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Advanced CHAIN OF CUSTODY ECORD <br /> GeoEnviron mental, Inc. Datta 10001 Page of <br /> 837 Shaw Road - Stockton, California- 95215- (209)467 1006 - Fax (209) 467 1118 <br /> Client T ref project Manager <br /> T 1 &\ e I�r Tests Required <br /> Phone Number <br /> (kl` 1- O <br /> - - <br /> Samplers (Signature) invoice <br /> Project Name cj AGE <br /> � Client Els <br /> Sample Lavation Sample ype <br /> Date Time Water No of Notes <br /> Number Description Solid f� � <br /> Coinp Grab Air ContS a <br /> r <br /> �1 [� 7� I1 7�1 1�4��I X yX fi 84518 <br /> TUL 1�yg- X All --- <br /> `14 —%1& lIA70 1 Ilc�'- 1 �� ' 11701 �yyZ � 84519 <br /> ' 41 84520 <br /> qrnquts e y i afore eve ve y i nalr�re <br /> � (f f 0 01 D la/Time <br /> Retlnquished y (S 9 ature) Received by (Signature) ate/Time <br /> Rel nqulshed by (Signature) Received by Mobile laboratory for field analysis (Signature) Dalefftme <br /> Dispatched by (Signature) Date(Time Recelved ter Laboratory by Dale/Time <br /> i <br /> Method of Shipment laboratory Name <br /> - .. <br /> illi (+ np� mTT[s OTH[P - I hereby authorize the perfor ance of the above indicated work <br /> �EltYttrlV <br /> 4y— <br /> V0 ) lJa 3 —f <br /> GOT U11,,9ITION V APPRr,'Vf;fAT[ <br />