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Advanced CHAIN OF CUSTODY RECORq, <br /> Date y-2-0 3 Page Z- of Z <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road-Stockton. California-95215-(209)467.1006-Fax (209)467.1118 <br /> Client IJA Vet- Sc;,l zap ;r Project Manager <br /> Tests Required <br /> ufred <br /> Phone Number <br /> Sampler (Signature) Invoice: <br /> 5 <br /> AGE <br /> Project Name � <br /> ;V ec t �� C� v Client <br /> Z�b <br /> Sample Location Date Time Sa le Type Solid No. of Ltv} v�vti Notes <br /> Number Description Water Air Conts. <br /> Comp. arse. J �/ <br /> ST _ 0 A l ea�e Stac.K ler 4-3-OL I S'l l /� ^ T G„fie <br /> STK-Z 4C eSr;� ��oc ; \z ►S�3 x X / / stun <br /> ST►G-� to&s+earl S+oc- ;iL i51Q ) /� � <br /> e w e natuLel. <br /> Receivedy gnature Dale/Time ... <br /> ���r 'I� Mcxtc nc �-2o3� /fa CJ <br /> R squished by:,(Signaturs) Received by: (Signature) Dalen"Ime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Dela/Time <br /> 2 L <br /> Method of Shipment: p ILaboratory N eC/'GS 1/ / <br /> lam(. over-K, � T2C61 <br /> Special Instructions: � / 1 hereby authorize the performance of the above Indicated work. <br />