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f Advanced CHAIN OF CUSTODY REdOAD <br /> GeoEnvironmental, Inc. Date6- 36 Y- Page of <br /> 837 Shaw Road-Stockton, California-95216- (209)467-1006- Fax(209)467-1118 <br /> r 0 � _ 1,9\3 <br /> Client Ct u N Project manager <br /> + , Tests Required <br /> Phone Number <br /> 6,7 /a)6 <br /> Sam ers (Signature), / Invoice <br /> Protect Name � AGl~,R <br /> e— <br /> Sample Location Sam a Type <br /> Number Description Date Time Water Air Solid Contsf Client <br /> Notes <br /> Comp Grab <br /> �'3 FA ° 12 q,a <br /> 12 -LI o 1 1 <br /> IF <br /> D� <br /> Z, <br /> , tura <br /> Receivedy gnalure <br /> Date[Time <br /> ,Zhedby <br /> {Signature} Received by (Signature) <br /> Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) <br /> DatslTima <br /> Dispatched by (Signature) DatelTime Received for a oratory by c <br /> Date/Tlma <br /> Method of Shipment <br /> ' abor y m re- <br /> �l <br /> Special Instructions � } <br /> '�_X/ //' i hereby authorize the performance of the above indicated work <br />