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ij IMF <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 3 Page / of <br /> 837 Shaw Road- Stockton, California-95215-(209)467-1008-f=ax (209)467-1118 r <br /> Client Protect �nagero e_ Tests Required <br /> Phone Number <br /> 4o /006 , <br /> Samplers (Signature) Invace <br /> Protect Name �. )C�� l� � �'�� AGE � <br /> UV �r i C� D� [0i PLf <br /> � f ac x Client <br /> Sample Location Sample Type ry <br /> Number Description Date Time Water Solid No of ,�� ti Nates <br /> Comp arab Air ContS <br /> h40 l 65.A7oS 1vt W 5'a7 ' <br /> ILJ 46v7.1O3 1 f,�.1 d� /z <br /> X14 3L,05 A763 MQ -3 I7 S <br /> JA!5 70 3 M W a <br /> ru 05 703 yv%,W 5,4 //J3 <br /> iaJ J 05_;L703 r-tfJ.) J 16417 <br /> ,i c-39-703 1 I+w w'S e ©9-33 �. <br /> e n is e y ignature Received by 1gnature f)atelTima <br /> R inquished by (Signature) Received by (Signature) ���a 1� <br /> DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) � Date/Time <br /> __L <br /> Dispatched by (Signature) Date/Time Received for Laboratop <br /> Date/Time <br /> Mathod of Shipman borat N <br /> i <br /> Special instructions I hereby uthonze the performance of the above In work <br />