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CHAIN OF CUSTODY RECORD <br /> t Advanced <br /> GeoEnvironmental, Inc. Date40-1 Page 2 <br /> 4005 North Wilson Way-Stockton,Californla-95205-(209)467-1006-Fax(208)467-1118' /4036>z P+CsE SD <br /> ' Project Maneiger Tests Re uired <br /> Client �� GtP—lr$��l/�-� ' ! ►.�/C�G I—>f� Q <br /> Phone Numbelf <br /> Samplers: (Signature) Invoice: <br /> ` ,)KD <br /> Project Name / Client Q <br /> Sar ipie Type <br /> Sample Location Solid No.of <br /> [ Number <br /> Description i Date I Time wader CoAir Coms. <br /> 7� Comp. Gra <br /> b. <br /> VCAS ftsM� vmg s <br /> 10 <br /> pl:k At <br /> 3: 37 , -- - <br /> t <br /> rnque e� y. ig re) ` eceiv y: gna w3 r— ,��- z �,�y'+� Dati1T e, <br /> ,ter—ITJ+/►T'9 rT 7 3 <br /> Rall shad by: (Signa ure) Rece' d by: (Sign ) <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) DatefTime <br /> Dispatched by: (Signature) Dale/Tima Received for aboratory by Data(Time <br /> t <br /> eTfir/ordnof Shi men(: J ^, <br /> Laboratory Name <br /> `('•Q'I / / I hereby authorize the perlo mance of the above bbfovvSlee iindicated work <br /> Special Instructions: /� � , ! �/� ` <br /> Zk 04 48= <br /> ffinDf.0NDITION / APPROPRIATE / <br />