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*Advanced <br /> CHAIN OF CUSTODACORD <br /> GeoEnvironmental, Inc. Date 4?-7-7--17 Page l of <br /> of Northern Califonua Q <br /> 1803 West March lane, Suite A-Stockton,California-95207-(209)956.0264-Fax(2D9)956-0700 <br /> Client f Project Manager Tests Required <br /> Kevto� AIC/4 ` <br /> Phone Number �r <br /> AWC h <br /> Samplers (Signature) �� Invoice <br /> �1 AGE <br /> Project Name A E1 ;,} � Client ❑ <br /> o- <br /> p-�' <br /> Sample Location Date Time Sample Type Solid No of <br /> Number Description Water Comp arab Air Coats <br /> 017 Vl> <br /> �B kngUlS e�DY ( kg tura} Received Sy rgnature ppatatTime � <br /> Relinquished by (Signature) Received by (Signature) tvf D telTime <br /> a <br /> Relinquished by (Signature) Rec4fted by Mobile Laboratory for field analysis (Signature) d telTkme <br /> Dispatched by (Signature) DatetTime Received for Laboratory by Dater ime <br /> Method of Shipment - /t r? C Laboratory Name � <br /> C 1 l 3LL� jtti <br /> dv?�;g4 Lu'T-�- f- 1i%VA 1 9 1r, " ' '-n Q121414 <br /> Special instructions k4t hereby authoriA the performance of the above indicated work <br /> +�— Vim' , <br />