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t _ Advanced <br /> GeoEnvironmental Inc. CHAIN OF CUSTODY RECORD <br /> - <br /> 2 Date page l/ of l <br /> 837 Shaw {load - Stockton, Cahforrna-95215 - (209)467-1006-Fax (209)467-1118 <br /> ' <br /> Client <br /> L Ru S I�g�S 1'j/j n Protect Manager <br /> f Tests Required <br /> GZn Phone Number <br /> Protect Name Ott, � <br /> Samplers, (signature) � Invoice <br /> 4�'� �� r'J AGE ❑ <br /> �Sample Location Sample Type <br /> Number Description Date Time Water Air Solid No of CIIBrIt, <br /> �'� <br /> Comp Grab ContS Notes <br /> Vvu <br /> l so 4( <br /> 03 ✓ <br /> 5� <br /> ✓ Valoho <br /> GOOD C.ONDrMN <br /> HEAD SPACE ABBEN!' ✓ COONTO �' ✓ <br /> F <br /> � / ✓@S <br /> eiinqurs e y ( ignature) <br /> ece ve y gnature <br /> `' <br /> He inqus ed by (Signature) �Y-3 rnnG <br /> Received by (Signature) ' <br /> Date(Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature} <br /> Dispatched by (Signature) Date/Time <br /> Date/time Received or aboratory by <br /> DatelTtme <br /> Method of Shipment F "Sc <br /> Spacial <br /> ri 1 Laboratory me 1 u <br /> Special instructions t1 V } <br /> ! hereby authoriz the performance of the above Indicated work <br />