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Advanced CHAIN OF CUSTODY RECORD <br /> -- GeoEnvironmental, Inc Date it Page of 2 <br /> 837 Shaw Road - Stockton, California- 95215 (209) 467 4006 - Fax (209)467-1118 <br /> Client Project Manager <br /> � �� r Tests Required <br /> � <br /> Ph neN inter <br /> riplers (S atur ) Invoice <br /> Project Name �r C-tet a AGE L) Client El <br /> Jkla <br /> Same e ype Sample Location No of <br /> Date Time Number Description atarab Air Solid Conts Notes <br /> Comp <br /> T <br /> V- <br /> etSby (S�grn-Ftur-E) �S <br /> ecewe ` r na J Date/Time <br /> 11 2k CA-A <br /> Received by (Signature) Dale/Time <br /> Relmquished by ;Signature) Received by Mobile Laboratory for field analysis (Signature) �ST/k�7—T DatelTime <br /> I <br /> Dispatched by (Signature) DatelTlme Recawed for Laboratory by Date/Ttme <br /> Method of Shipment Laborator Name <br /> Special instructions ° 1 ����'\ � CA i herehy orixe the pe rforht indicated work <br /> All, <br /> GOOD CONDITION APPROPRIATE REUD SEALED & INTACT VIA <br /> ItI AD SPACE ABSENT CONTAINERS <br /> .11 An PAESEIZ\r -r{l-t <br /> VOAS 4 0&0 1 METALS I OTHER <br />