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il""""` r r-- ir' ir— r r r ir- • r r ir- ir' r r ir- r ir- r <br /> Advanced CHAINF CUSTODY RECORD <br /> GeoEnvironmental, Inc. bi 1t:; Date Page Of1995NorNtS a� Stockt Callfornia-952!15 (209)467-1006-fax(209)467-1118 <br /> .3 �. <br /> Client A ir > a Project Manager <br /> gi L4 & Tests Required y. <br /> Phone Number <br /> Samplers: (Signature) ' k� Invoice: <br /> Project Name ` GJ� q AGE <br /> l �+t'� rt � jc G✓J�'j S Qi �4� Client <br /> Sample Location Sample Type No. <br /> Date Time Water Solid of �� � � �Q` v Notes <br /> Comp. (arab. <br /> Number Description Air Conts <br /> 60638 <br /> 60639 <br /> t,.s -90 X15 60640 <br /> Bl?, -.3D 3z 60641 <br /> r�)Y- 90 q !d <br /> 60642 <br /> 3-D 1 4q Z- 60643 <br /> e in a e gnature ace ve y: (Signature) C <br /> Relinquished by:(Signature) Received by: (Signature) � /lry 1 I � <br /> Dataf 1'Ime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) OntelTime <br /> Dispatched by:(Signature) DaterTime ace ve or Laborator , tafTime <br /> Method of Shipmen• oratory Name <br /> �� PRESERWITION C <br /> Special Instructions: GOOD CONDITION APPROPRATE I hereby authorize the performance of the above Indicated work. <br /> HEM SPACE <br /> V _ <br /> VV �� <br />