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i- <br /> s • <br /> CHAINF CUSTODACORD <br /> Advanced <br /> t _z__--= GeoEnvironmental, Inc. Q r awe fiq Page �— of <br /> 837 Shaw Road - Stockton, California-95215- (209) 467-1006 - Fax (209)467-1118 <br /> Client L L(J( C, Pr lna er <br /> —1c-t -e Tests Required j <br /> Phone N tuber <br /> Zd 1(0-1 T <br /> Spaiglers (Signature) Invoice <br /> Project Name AGE)4 <br /> Client ❑ <br /> Sample Type <br /> Sample Location Date TimeWater Solid No of Notes <br /> Number Description Air Conts ti <br /> Camp Grab <br /> , <br /> :(5LOs its- 44 6� u 4q X, 11 C")Ci <br /> ignature Received by'-(9-eg`F-a-Eu--reFDa effimrr ^�!1 <br /> Relinquished by (Sig re Received by (Signature) Date(Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date rime Racer d or Labor ory by Date/Time <br /> Method of Shipment lam` Lab l ry Name <br /> Special Instructions 1 here authorize the peri ae o e above Indicated work <br />