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CHAIN OF, CUSTOD RECORD <br /> Advanced <br /> GeoEnvironmental, Inc. Date 1 Page __I_-_ of <br /> 837 Shaw Road Stockton, California 95215 (249)467-1006- Fax (209) 487-1119 <br /> Client 11►�4ti J(,Q <br /> Project Manager <br /> Tests Required <br /> Phone Number <br /> 67c) `s l <br /> Samplers (Signature) Q Invoice <br /> + <br /> Project Name AGS <br /> `'� Client ❑ <br /> � Cit- rip j <br /> Sample Type <br /> Sample Location No of / / <br /> Date Time Water Solid Notes <br /> Number Description Comp Grab Air Conts <br /> { `� <br /> t z t1rg �� XIx I - <br /> 2/ \Ook <br /> kyr 3 t�W 3 <br /> tO64/ X i <br /> IL <br /> iinquis e r tura stews y +gnature D IelTt <br /> Reim uished by (Si nature) Received by (Signature) DatalTi e <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) STAT Date/Time <br /> Dispatched by (Signature) DatelTime — Received for Laboratory by /-1 Date/Time p <br /> Method of Shipment Laborato n er <br /> cc <br /> Special Instructions k, I hereby authors:a the performance of 'h® above +rtdreatea work j <br /> /UVJ !I Jl i <br />