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� Advanced <br /> CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. -o Date �s�� page I of <br /> 837 Shaw Road Stockton, California-95215 - (209) 467-1006- Fax ( 09)467-1118 <br /> CUentg2XC! Protect Manager Tests Required <br /> ,[L 1. ��/:4-e <br /> Phone N mber <br /> Z 416 -- /WCC <br /> Samplers (Signature) Invoice, <br /> AGE <br /> Project Name �� ' A �CVX-J�� �' Client ❑ <br /> Sample Type <br /> Sample Location No of <br /> Number Description comp <br /> Time Water Air SolidNo <br /> / � Notes <br /> Comp Grab <br /> t 90613 <br /> s"� � �- /Sa ` W 90614 <br /> .,.►�.»zA/ s-�o - 1Z z`, +1 90615 <br /> 141a �a�" -�/,s: •� ; {r) 90616 <br /> v� S-0-2 l i,3-7 <br /> ti 906 7 <br /> ®inquis a Signature) Receivedignature Date(rlme <br /> Relinquish y J,gTIOT .F Re ry by a ure� l 0 2 �— Dalelllme <br /> Relinquish (Signature) Received by Mobile taboratori for field anatysis (Signature) Datelfime <br /> Dispatched by (Signature) Datelfime Received for Laboratory by Date/Ttme <br /> Method of Shipment Laboratory Name <br /> Special instructionsn�j�QJ tr�1 I hereby authorize the performance of the above indicated work <br /> OT <br /> I• V r G L - <br /> / <br /> 17 � AI f Jrll/I'FIL 1 <br />