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w <br /> CHAIN QF CUSTODY RECORD <br /> Advanced 10 7lg <br /> � � <br /> --- GeoEnvironmental, Inc. Date age 2- of <br /> ~' 4005 North Wilson Way-Stockton,California-95205 (209)467-1006-Fax(209)467-1118 <br /> Client Project Manager Tests Required <br /> )eII <br /> Phone Number <br /> (ao o y&7- /00i' <br /> Samplers (Signature) Invoice <br /> AGE � <br /> Project Name Client <br /> T. �'1 ern S+"�4 4-an 95-O l 2 o0 � �� E] <br /> Sample pe 3. �A� <br /> Sample Location No of c� a Notes <br /> Date Time Water Solid ,t., n <br /> Number Description Air Conts <br /> Comp Grab VV I 51914 <br /> �w�g� 0� UO I1J I� "z7-c>�l I'5'A 0 ^ - - <br /> QQ'w3 51925 �);!o-�7rva 155 � k <br /> t <br /> e s e ( ignature eca ve y ignature DateMme <br /> Relinquished by (Signature) Received by (Signature) N Date €me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/T€me <br /> i <br /> Dispatched by (Signature) Date/TimecV?� <br /> Labor ty by Date/Time <br /> Method or Shipment Laboratory Name <br /> UqrA 'IG, 7 <br /> ��}}11 [r C <br /> chon <br /> Special lnstrus WAS 0&G METALS OTHER i hereby authotizi the aerformance of the above indicated work � <br /> 006CONOITI5NAPPROPRIATESKE 00 - - <br /> " <br />