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CHAIN PF CUSTODY RECORD <br /> Advanced Page z <br /> melte <br /> - GeoEnvironrnental, Inc. W <br /> s 837 Shaw Road-Stockton,Catlfornla.-96215- (209)467-1006-Fax (209)467-1118 <br /> client � P Tests Required F- <br /> t � I <br /> 1718 umber <br /> II 9173' (SignInvoiAGE FeK <br /> ce. <br /> Project Name A--�aclt Client ❑ r) <br /> Sample Type r r <br /> No Of <br /> Sample Location Date Time Water Air soiid Notes m <br /> Number Description Comp Crab = <br /> r --r t LOIs, <br /> a _ 0? <br /> VOW q 6 OTALs- <br /> 1 <br /> olio <br /> U d5� - rota <br /> aterFlraa <br /> e mq s e n urs Received y Qaaturo <br /> D /soda N <br /> Date�Clms �N <br /> Relinq ishad y ( rgnalure} Received by (Slyoature) n1 <br /> DatelTlma ro <br /> Relinquished by (Signdlura} Received by Mobile Laboratory lar held analysis (Sl9nature] ti <br /> QaterTlme <br /> Receive for burato y DalelTlrn <br /> Dispatched by (Srgnelare) C <br /> -I <br /> bora erne � <br /> Method 01 Shipment � m <br /> D �A <br /> r <br /> 1 hereby au or a the per rs<ence of i e above indicated work <br /> Special Instruchons <br /> V! <br />