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Advanced CHAT OF CUSTODY RECORD <br /> ( 1 <br /> GeoEnvironmental Inc. Dated �- Page l f <br /> D S oO I <br /> 837 Shaw Road Stockton California- 95215 - (209) 467-1006 Fax (209)467-1118 <br /> Client , Project Mana er„ <br /> � 31 71(?� 41 �s I (�k - Tests Required <br /> {. <br /> Phone Number <br /> Samplers (Signature) ✓1 Invoice <br /> Project Names r Y a�' _ { 4 �_ s / i <br /> i � 1`�'r'� ., }`� � �.,� _ / Client ] <br /> Sample Location Date Time Sample Type Solid No of � ` � Notes <br /> Number Description Water I Air Conts <br /> Comp Grab <br /> tC <br /> GOO ATR tom" <br /> CO M <br /> HLA SPAPEW <br /> DECI LO AT 0 D LAD; R 3SERD <br /> VC ASX O&C I M frAU I OTIOR _--- _ <br /> PRE &R TI <br /> j e,mquis a y ( i Received by (Signature) Date(Ttme <br /> Relinquished by (Signature) Received by (Signature) FA Date[Tkme <br /> Rehriquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Daterrime <br /> Dispatched by (Signature) DalelTime Re A boralory by <br /> Method of Shipment t aborator e <br /> RECD S C� � <br /> Special Instructions I hereby authors a the performance of the above Indicated work <br />