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Advanced <br /> CHAIN OF CUSTODY RECORD <br /> _--- GeoEnvironmental, Inc. Date Z-1-6•s Page of Z <br /> 837 Shaw Road -Stockton, California-95215 - (209)467-1006 - Fax (209) 467-1118 (D 2 3 <br /> Client S Project Manager V Tests Required <br /> Phone Number <br /> Samplers ignature) £� Invoice: <br /> Project Name 4�, � Client <br /> �e'A&t yl �Ot1 �o� / v <br /> 51 <br /> Sam <br /> Sample Location Ype No. of 0 <br /> Number Description Date Time Water Air Solid Conts. �` v Notes <br /> Comp. Grab. <br /> L1- .20 L�l L--ie, 010( S O S s- U< 1 <br /> LL 2 0 to as l 6 i 3 <br /> LC /o�oyvs 103� <br /> Lc-y ozo os lolls o� x <br /> LL S/ozvyos o <br /> PC <br /> LL-7/u��os 153X1i� <br /> / i e <br /> e� ad (Sinatur De <br /> 1 30 <br /> quished by: (Signature) Received by: (Signature) Date/Time, <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Data/Time Received for Laboratory by: Date/Time <br /> e- Y��' _ 9,PtL- <br /> Method of Shipment: Labor at Name <br /> Cu over. �- <br /> Special Instructions: I hereby a thorize the performance of the above Indicated work. <br /> IJD �p <br />