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( Advanced CHAIN OF CUSTODY RECORD <br /> Geol✓rrvrr onrncntal, Inc. Date ��v3 Page _Q__of_rz, <br /> 637 Shaw Road Storklon, California- 95215 - (209) 4671006 - Fax (209) 467-1118 <br /> Client; _ Pro ect ManacverVyJ -- <br /> Tests Required <br /> Phone Ntuber <br /> Samplers (Signature) },�� Invoice <br /> Project Narne `` �� AGE <br /> VClient ED/1 i <br /> Sample w Location Sample Type <br /> Number Description Date Time Water Solid No of ! �� /�/ Notes <br /> Comp Qrah Air ContS /V <br /> W <br /> t0 ,kk2.e_,qUP &k3 t. Ll <br /> w 1D D kloco5 mak: lG D <br /> JAD,PACT,AAS.NT CONTAINERS OD iTIO APPROPRIATHkO Il <br /> i <br /> L-IC'C' VOAo&a MTALs I 01Mx <br /> P ESF VA ION <br /> lIe inquis e y I ature) — Received y ignature D le[rr a <br /> Relinquished by (Signature) Received by (Signature) DatelTlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date(Time <br /> Dispatched by (Signature) Date/Time RbeelVed! r Likboratory by J]ale/Tima <br /> � 4 <br /> Method of ShipmentLab <br /> orala y Na e <br /> CO C ve f y 1,C <br /> Special instructions r r �t - ��/J J hereby authorize IhJ performance of the above Indicated work <br /> REUD SEALED & INTACT VIA A <br /> v <br />