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CHA1 OF CUSTODY�ECORD <br /> [ Advanced <br /> Dat q as page I of <br /> --- GeoEnvironmental, Inc <br /> 837 Shaw Road Stockton, California- 95215- (209)467-1006- Fax (209)467-1118 <br /> ClientP e act Manager Tests Required <br /> V C—rar 1M,'�]�i�,{,� <br /> (Phone Nubei <br /> S lens at � �� ��� <br /> Invoice <br /> AGE <br /> Project Name C` ' Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid NO of n' ( Notes <br /> Number Description comp Grab Al COntS <br /> C-M- <br /> �W3 <br /> I � <br /> in urs e ( igna re eceive y (Signature) Qate1T me <br /> � v-3U <br /> ReTnTrtruished by (Signature) Received by (Signature) QateFrime <br /> i <br /> i <br /> Relinquished by (Signature) Received by Mobile Laboratory for Reid analysis (Signature) Qate(Time <br /> I <br /> Dispatched by (Signature) QatelTime Received for Laboratory by Date <br /> /Tima <br /> Q- L <br /> Laborat ame <br /> Method of Shipment <br /> Special instructions <br /> I here uthoriza tf+ parlor ce of the above indicated work <br />