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Advanced <br /> iced CHAIN OF CUSTODY-RECORD <br /> GeoEnvironznental, Inc Date V _&�17 page ! of <br /> of Nor7hC171 CahfrirTtra <br /> 1603 West March Lane SWe A Stockton California 95207 (209)956-0264 Fax(209)956 0700 <br /> Client [ Project Manager Tests Required <br /> L z_ _ <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name {1 �{ rj _ AGE Z�,- <br /> Client ❑ <br /> Sample Location Sample Type / <br /> Number DeDescriptionptlo <br /> Date Time Water Air Solid No -Notes�_�y <br /> Comp Grab t <br /> 72585 <br /> i t t <br /> + 1 7 Z ° ✓ 3 72585 It <br /> r z- 1 ✓ X2587 <br /> I_ <br /> I <br /> Relinquished y_(Signature) <br /> /-3-97DatelTi <br /> , me <br /> Ret1 r.CCw 1ci fll 'E` 774--rG &} 4L3" <br /> Relinmq /Q se) lit ur a by (Signature) sued by (Sig tore) Date/Ttme <br /> Relinquished by (Signature) deceived by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DateJTtme Received for Laboratory by Date/Time <br /> Method�of !fir ent0Laboratory (MameSpecialuctions I hereby authortzn Yhe performance of the above indicated work <br /> VU G <br /> I v <br /> AMS J <br /> t' JCD OONDIr0Pi APPROPRIATE <br /> J7, 'Cplf C AOUNIT 24 fln TTkIlF`IM2 --- <br />