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� Advanced <br /> CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date e l-11& Page <br /> 837 Shaw FAoad-Stockton,California-95215- (209)467-1006- Fax (209) 467-lite _ <br /> Client -b�� Project Manager Tests Required <br /> Phone Number <br /> Sa lers (Signature) Invoice <br /> ACE IV,'A <br /> Project Name --�—; L l 4 , 1_ /�, Client ❑ <br /> Sampke Type r <br /> Sample Location Date Time Water 601id No of Notes <br /> Number Description Comp Grab Air Conts <br /> i <br /> 7ul—l. e y { �4 <br /> eceive y (Signature) Date/Time <br /> 7 <br /> Reinquishe y ( alure) Received by (Signature) Date(Trme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) 92, <br /> Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by , DatelTime <br /> if \ ? <br /> Method of Shipment LabOF61yfyName <br /> 5 <br /> Special inalrueltans t r--v y t I hereby authorize the performance of the abov tticated work <br /> �T <br />