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CHAIN OF CUSTODY RECORD <br /> { Advanced Date "`z -L Page J_- of�-- <br /> GeoEnvironmental, Inc. Vie,., U-4r - <br /> 4005 North Wilson Way-Stockton Cahfomia-95205-(209)467-1006-Fax(209)467-1118 <br /> Client <br /> Project Manager r !' r, f/ Tests Required <br /> ( Tj <br /> Phone Number � <br /> �l 7- (ad C <br /> Samplers (Signature) Invoice <br /> • � �� AGE <br /> Client <br /> Prosect Name slep eo M al*-t 0 e- p � <br /> Sample Location Date Time Wa merle Ty ear Solid No of ��� _Notes <br /> Number Description Comp arab Cants , <br /> 3 X No►92843 <br /> f <br /> I <br /> 7( 3 No.92845 r —Y , <br /> /'+ T( ,/ .fix// 1 No' �'sz�:R, <br /> —2— �q ��J _ ` /\ i q z <br /> l [/ Y - � 11 <br /> --` 1� 1 • 1 No 92 u <br /> � 2-�' t <br /> .B 4 .l— <br /> : r <br /> 6 �, �Y _ �� } , �61 Y No. 92848-' — <br /> -t- r <br /> C d Date(Tkme7 y <br /> e In u}s a Ign use ces rvg Y ig ature +� p �d ✓�"` 7` <br /> Daie(Time <br /> Relinquished by {Signature) Received by (Signature) VnV <br /> + d <br /> Rehnqu shed by (Signature) Received by Mobile Laboratory for lieid analysis (Signature) <br /> Received for Laboratory by +Jr p D r•;LF pt)SE4� ��n ateJTima <br /> Qaleffima nit +i„ _ t�,,i I IC i�I`rl0 <br /> � <br /> Dispatched by (Signature) <br /> Matho I of ShiLaboratory Name <br /> pment ISO l <br /> [ v er�v� , <br /> I hereauthor{ the perfor enc of the above indicated work <br /> Special Instructions <br /> Q � <br /> i <br /> �, lev <br />