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� � � � � � � � � f• f• � f• l• f• s• titil• ttitititii ftititititi• <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 1�6L Pace j _ 1 <br /> 837 Shaw Road Stockton, California -95215 -(209)467.1006- Fax (209) 467-1118 <br /> Client �� *r"" Project Manager Tests Required <br /> +uL i,F e ter'" <br /> Phone Number <br /> "7 166(e <br /> Samplers (Signature) ��� Invoice <br /> Project Name I AGE <br /> Client ❑ <br /> Sample Location Date Time SarIe Type No of <br /> Number Description Water Air Solid Corrts � Notes <br /> Camp Arab <br /> +l: l 04 ru I 631.7 oq 1(3o <br /> -2 ft <br /> "I VAI ZI 40 <br /> e in is a gnature ece ve y rgna4ure oate(Ttme <br /> 4.�rgr'6y lc:.�� <br /> mqutshed by (Signature— Received by (Signature) Daleffime <br /> �r <br /> GOOD)CONDITICYX,,,,,.,,,.,r,. �P <br /> Relinquished by d by Mobile Laboratory for field analysis (Signature) DatelTime <br /> T)ECHLORINATED IN LAB----JIM <br /> MBMUA fr <br /> 7v <br /> Dispatched by ( ATItRi DatelTlme Ree 1 laboratory b <br /> 1�alejTlrne L_ <br /> Method of Shipmentr Laboratory me <br /> RECD SEALED&INTACT VIA C C-) <br /> Special Instructions `, !'/ i hereby authorize he performance of the above indicated work 1 <br />