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� �� l• � 1• � � � � s �� �� ,_ � tftttttfffifaZ <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvi ronmental, Inc. Date C15 '`1-�-7 Page --L of <br /> of Northern California <br /> 1803 West March Lane Suite A Stockton California-95207 (209)956-0264-Fax(209)956-0700 <br /> Client Pi a NJ -T; L �� Project Manager Tests Required <br /> F�,->M C""C1 <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Protect Name AGE%�o <br /> Cl <br /> Date Time ient <br /> Sample Location Sample Type Solid No of � Notes Number Description Water <br /> Comp Grab Air Conts <br /> b RA55 <br /> `6,�q <br /> <6- <br /> 2- <br /> zu zJ 9't15 <br /> "o+ z5' Ci '.z`�-h <br /> 2,,-3 _, r'Cr4 ;C� q 5q <br /> PZ-- 35 4 3S' �J Cti k, V <br /> e inquis e y (Signature) I i ecei a by —(91 g n a—tu r e) ll Date/Time <br /> CJct�fCL '\/- 5Q0 <br /> Relinquished by (S tgna ure) Received by (Signature) f Datefrime <br /> Relinquished by (Signature) Received by Mobile laboratory for field analysis (Signature) Dale[Time <br /> i <br /> Dispatched by (Signature) Date/Time et for Laboratory by Date/Time <br /> 5®� S-& o;�a- <br /> Method of Shipment Labor tory Name n <br /> CA b I�- <br /> Speetaf lnstructtons ii f� I hereby authorize the performance of the above indicated work <br /> C q 2 'F �+ iZ <br /> J <br />