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t Advanced CHAINPF CUSTODY RECORQ <br /> 1 r-, � t <br /> -_ - GeoEnylronmental, Inc. Date Page .� of <br /> 837 Shaw Road- Stockton, California- 85215- (208)467-1006- Fax (208)467-1118 OS-...- 1 1 <br /> Client Af DEL UA Pro ect Manager <br /> �t , ' . �; a�� Tests Required <br /> Phone Num r - <br /> �s tic <br /> S lers (Signature) invoice: <br /> I (gc !R - AGE <br /> Project Name � p Client <br /> Sample Location Sample Type <br /> No of <br /> Number Description Date Time Water Alr Solid Conts Notes <br /> Comp Grab <br /> Rai 7-0 nq igpre Received y gnature <br /> atgDatelTtme <br /> el nqutshed by ( ignature) ` Received by (Signature) 'l' Daterrime <br /> w <br /> Relinquished by Slgnalure) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) DatalTima Received for Laboratory by DatefTtma <br /> �a 3 4q <br /> Method of Shipment ! a oratory Name r <br /> V � 4 <br /> Spacial Inelrucbons I hereby authorize the performance of the a in Icated work <br />