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lt� Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental Inc. <br /> ~" Date Page 2-- <br /> 400 of <br /> 5 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 _ <br /> Client <br /> Project Manager <br /> Tests required <br /> Phone-Number <br /> Samplers: (Signature) <br /> Invoice: <br /> Project Name <br /> AGE <br /> Sample ,( Client ❑ <br /> Location Sample Type <br /> Number Description Date Tarte Water Solid No. of <br /> Camp. Grab. Air Conts. Natn� <br /> 1 12449 <br /> X 12450 <br /> r .S t' <br /> r <br /> 1e45 � <br /> 2452 <br /> iLI-5- <br /> k 12453 <br /> _7Telinq d by; {Sig at e � r4 y����_ <br /> ecewe y: ( ignature <br /> Relinquished by: (Signature <br /> Received by: (Signature) V�1 <br /> Relinquished by: (Signature) Date/Time <br /> Received by Mobile Laboratory for field analysis; (Signature) <br /> Date/Time <br /> Dispatched by: (Signature) _ <br /> Date/Time ER OTH <br /> Received lor Laboratory k';:MER <br /> SAS I O&G ME AC,` DatelTime <br /> Method of Shipment; ICE/10PRESERVATIOk! <br /> 1 Laboratory Name <br /> Spacial Instructions: 1 1� <br /> HEAD SPACE ABSENT CONTAINERS I hereby authorize the performance of the above indicated work. <br /> Com[ v < t�- , <br /> btr CCLIc�n�g -� <br />