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( AdvancedCHAIN OF CUSTODY RECORD <br /> =_- GeoEnvironmental Inc. ' Date Page _�_' of <br /> 837 Shaw Road-Stockton, California-95215- (209)467-1006- Fax (209)467-1118 <br /> Client PTet Manager <br /> ,�� Tests Required <br /> Ph ne Number <br /> Sawlers (Signature) Invoice <br /> t <br /> Project Name f f AGE <br /> Client <br /> Sample Location Sample Type <br /> Number Description Date Time Water Air Solid No of Conts Notes <br /> Comp firab <br /> e in is e y ignature Receivedy (Signature) <br /> DeterTime <br /> Reim wished by (Signature) Received b Si nature �� <br /> Y [(Signature) Dateri im <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DaterTime Received for Laboratory by� DaterTime <br /> _4 "" (��' an <br /> Method of Shipment Labo N <br /> Special instructions I he y authorize the performance 5Whe abov indicated work <br />