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Advanced 72— CHAIN OF CUSTODY RECORD <br /> GeoEnvironmentai Inc. <br /> Date.}��Ib C�� Page -'-L of <br /> 837 Shaw Road- Stockton, California- 95215- (209)467.1006- Fax(209)467-1118 <br /> Client ��� _ " " �,� �� ,^ Project?)AlnagTale, <br /> Tests Required <br /> G' i <br /> PPone N mber <br /> Samplers: (Signature s �`2t Invoice: <br /> Project NameAGE <br /> Client <br /> Sample Location Sample Type <br /> Date Time Water Air ContSolid No. <br /> of <br /> Number Description s. Notes <br /> Comp. (arab. � <br /> 3` 0 rr y p �( <br /> I <br /> W <br /> s a y: (Signature) Received y: rgnature <br /> f)atelTime <br /> �— --- I4 /L-,`d3 <br /> Re quished by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) T DatelTime <br /> Diapatched by: (Signature) Date/Time R@71 o abor ory by: D te/Tlme <br /> Method of Shipment: Laboratory NrVe <br /> C� �� <br /> Special tnstiuctions: I here authorize the performance of t abov ndicated work. <br /> I <br /> i <br />