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3 <br /> ( Advanced �� �'�� �-�� CHAIN OF CUSTODY RECORD <br /> GeoEnvironrnental, 1IIC Date i Page <br /> 837 Shaw Road Stockton Califomia- 95216 (209) 467 1006 Fax (209) 467 1116 <br /> Client r Project Manager <br /> bt, —�; �- <br /> Tests Required <br /> L- <br /> -.hone Nu ber <br /> — — — _ Samplers (Signature) Invoice <br /> Pro)ect Name t - /� / AGE 2f' <br /> _ �o- �_ �'�e V vz)v l Client ❑ <br /> Sample Location Sample Type �a <br /> Number Description <br /> Date Time Water _ Air Solid No Gonof / / Notes <br /> Comp Grab <br /> ts <br /> i <br /> J\A, <br /> e in uis e (Signature) efi ceive nature <br /> _ U talTl <br /> q �� y \��1 <br /> Relinquished by (Signature) , Received by (Signature) ���� Dater me <br /> TCQII° <br /> _QjD <br /> O CONDITION PDP TB <br /> Relinquished by (Signa1QTQ)\D SPAC,EABSFNT CO bite Laboratory for field analysis (Signature) Date/Time <br /> DECHLORINATED IN LAB—PRE SERVED IN <br /> Dispatched by (SignaturWFSPRVATION ate/TimeRece a })� a orator byy <br /> f}ale/Tlme� I <br /> Method of Shipment Laborailory Ham ' <br /> C—�LN cue <br /> Special Instructions �� v ,•� !!' I hereby authorize the larfotmance of the above indicated work <br /> �.—L- gEC,D sEALED & i <br />