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i <br /> l Advanced CHAIN.OF CUS Y RECORD_ <br /> GeoEnviron <br /> -- - � menta, Inc. _ Dace <br /> ' Page` olf <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006 Fax(209)467-1118 <br /> ClientIS yU 2­4T67 <br /> Project Manager <br /> Tests Required <br /> i Phone•Number, <br /> Samplers: (Signature) <br /> Irnroloe:. <br /> Project Name <br />} AGE . <br /> Sample w Lj <br /> Client._0 <br /> Sam ' <br /> p Location Sample Type <br /> Number Date Time No. of <br /> Description Water Solid� <br /> s comp. crab. Air Conts. Notes <br /> �z� X <br /> -12469.1 ' ", <br /> -2470 <br /> -1247.1 <br /> .. : 1.2472 .. . ; <br /> Ivor Rsc,s lh;o <br /> 9' a ma rgns ure eceive JY,: ignature <br /> oats/lime ,s <br /> Relinquished by: (Signature) <br /> ., Received by: (Signature) r�J I _ ; <br /> Date/Time_ . . <br /> Relinquished by: (Signature) , <br /> Received by Mobile Laboratory for lisid analysis: (Signature) "'.OalelTime <br /> Dispatched by: (Signature) Date/Time Received lot Laboratory by: <br /> �t Oale/flme :. <br /> ! Method of Shipment: iCLJ� <br /> [,CJI 11VARON Laboratory Name <br /> Special Instructions: ��WC IIVty <br /> Af <br /> SIft KI ABO I hereby authorize the performance.of the above Indicated work. . <br /> AUABSa _.. CONTAINERS -- ; - <br /> Cil ovz4 ti)3. r* <br />