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( _ Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnviron mental, Inc. t Date 7 ' Page --L of J <br /> 4005 North• Wilson Way-Stockton,California-95205-(209)467-1006 Fax(2W467-1118 <br /> Client Project Manager . <br /> Tests Required <br /> Phonee Number <br /> Samplers: (Signature) Invoice <br /> Project Namej <br /> Z nom, AGE <br /> Client p <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid17 No. of Notes <br /> Comp. Grab. Air Conts. r --. <br /> - 9 ✓ k No.92522 <br /> I <br /> mat SD <br /> ::..: r:. . - <br /> No+ 92524 <br /> r - <br /> l I��f3 V/" ( ;V(No._92525-- , <br /> AW � �j t <br /> ( No.92526 <br /> o t�N-- <br /> i <br /> e mquu a y: ( ignat e e rve y: nature Date/Time <br /> V '12-Z ,;0 Am 1 J <br /> Relinquished by: (Signature) Received by: (Signature) <br /> Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: <br /> Date/Time <br /> Method of Shipment: Labors}ory N <br /> CO QC l�? S GI /l/f G Y <br /> Special Instructions: 10kG <br /> VOAS O&G METALS OTHER I hereby authorize he performance of the abo a indicate work. <br /> GOOD CONDITION APPR0PR!-",TE <br />