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I! <br /> i■ i i i i i i Ii i i i i i i i i i i i <br /> CHAIN O CUSTOD ECORD <br /> Advanced Date 9 Page —L- Of <br /> --- %'` GeoEnvironmental, Inc. <br /> 4005 North Wilson Way Stockton,California 95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Mana r Tests Required <br /> Phone Number <br /> 2e�9lsz� --\'00(Q <br /> Samplers SI nature) Invoice <br /> AGE <br /> Project NameClient ❑ <br /> � <br /> Sample Location Sample Type No of `� Notes <br /> Number Description Date Time r;ompf ter Air Solid ContsLkWZiH <br /> 1 <br /> ryt atelTrme <br /> coo <br /> e m Y l tui ecerve y ignalure T 7�7 <br /> t t batefrime <br /> Ralmqurshad y (S nature) Received by (Signature) <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Srgnalure) Dateffime <br /> I <br /> —Dispatched by (Signature) <br /> pate/Timo Received for Laboratory by I-----D6,a—tetT1r.ne <br /> Metho5h me 1 N- �If1Ln Laboratory <br /> d f N <br /> ,r I hereME by author�e I rm nee of the above indicated work <br /> Special Instructions GOOD CONDITION APPROPRIATE t <br /> 1+,r,FIA :A(1 k rc�- Ott <br />