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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. oats 2� Page of ` <br /> 837 Shaw Road-Stockton, California- 95215- (209)467-1006- Fax(209)467-1118 03 - 19 ,0 <br /> Clienti Project Manager <br /> S a + ,1 Lt' Tests Required <br /> P one l lumber <br /> � lz�—� '� <br /> Samplers (Signature) Invoice <br /> Protect Name � t� AGE <br /> { Cheat ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No of �� Notes <br /> Number Description comp Grab Air Conts <br /> a mquis y i nature) Reeelvirid by tgnalura � � OtefTi e��� <br /> Relinquished by (Signature) Received by (Signature) Date/time <br /> AAA i <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) �"'�� Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by ` Dataf ime <br /> Method of Shipment Laboratory N e <br /> jeCY L <br /> Special Instructions t` f/ I hereby authorize the performance of the above indicated work <br />