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Advanced CHAIN OF CUSTODY <br /> GeoEnvironmental, Inc Date t 9 Page 7 <br /> 837 Shaw Road - Stockton, California-952-15- (209)467 1006 - Fax (209) 467-1118 <br /> Client t ��� Project Mana Tests Required <br /> ti►„� �.`t✓ Com. � <br />�-_ Phone Number <br /> D�CP <br /> Samplers (SignJure) invoice <br /> AGE <br /> Project Name � 1 L <br /> r C Client ❑ <br /> Sample Location Solid Sample Type No of ' V� 1)21 Nates <br /> Number Description Date Time Water Air Conts <br /> Co.p7 Grab <br /> ixl i 1-3 I l JUL t313 It <br /> - w 9c, V%J 9 C1 I Jf L©cam <br /> FITL I <br /> e inquis a ignature) Received Ey gnature ,r Gate/Time <br /> ! <br /> (,��7�I / Ze r✓ i <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Ttme <br /> Dispatched by (Signature) Date[Time Received for Laboratory b DstelTi a <br /> -= Method of Shipment � ti � � ) - ` S7 L atary <br /> Special Instructions `„ � 1 hereb uthonze the perfarrKance of the above indicated work <br /> f�c e-e—W <br />