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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Dare I Z) Page of <br /> 1 <br /> 837 Shaw Road - Stockton, California-95215-(209)467-1006- Fax (209)467-1118 0 (� �j <br /> 7- <br /> Client Pro ect Manager <br /> L Tests Required <br /> Phone Numbgr <br /> Samplers (Signature) Invoice <br /> AGE Y <br /> Project Name t d�� l � ��u � ( Client ❑ <br /> Sample Location Sample Type <br /> Date Time Water Solid No of Notes Description Comp arab Ar Solid <br /> JbZ 3 <br /> L�11� lbs° ✓ 3 <br /> -J Lm <br /> Ion`' <br /> e in e�ynReceived-by rgna(ureDatelTime <br /> Relinquished by (Signatur Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory b Date/Tlm <br /> — L�� <br /> Method of Shipment L e <br /> 5pecla4lnstruatlona +1 I hereby authorize the performance of the above indicated work <br /> U 'U ad L <br />