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j Advanced CHAIN OF CUSTODY RECORD_ <br /> Date 8 7-03 Page —L— or <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road- Stockton, California• 95215- (208)467-1006 - Fax (209) 467-1118 <br /> i �- ProjectMana e <br /> Client r� � Tests Required <br /> Phone Number <br /> Samplers: (Signature) Q�" Invoice: <br /> Project Name {� \ -uv,, <br /> 1 AGE <br /> cSY� '. hL1 � Client <br /> Sample Location Sample Type No. of <br /> Number Descri tion Date Time Water Solid ^ Notes <br /> p Comp. Grab. I Air ContS. <br /> J / o- I ' V� <br /> - -7-03 wzp 4, <br /> PAO - (� (' \�f B -7-03 L03 <br /> -7- evs OLA 25.7-6-5 Ss k f <br /> 1• -7"03 1,0 05- <br /> X <br /> e inquis a y: igneture eceive y: ignature Date/Time <br /> Relinquished by: (Signature) I Received by: (Signature) T\ Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for La o air <br /> l by: Dale/Time <br /> Q3 CISH <br /> Method of Shipment: Laboratory A..t 4_ �� <br /> Special Instructions: �� �e fnl I hereby authorize the performance of the above Indicated work. <br />