Laserfiche WebLink
0 Advanced OF CUSTODY RECORD <br /> c�« <br /> GeoCllvtrol�melltal, IncDate r -jZ `� Page of <br /> 4005 North Wilson Way Stockton California 95205 (209)467 1006 Fax(209)467 1118 1 oa CD/_ G, <br /> 4 t lL C <br /> J` �_ � C <br /> Client SrProject Manager <br /> S�/_'c ' n C— �a Tests Required <br /> SiL <br /> Phone N mber / <br /> J <br /> Samplers (Signature) / �� Invoice <br /> Project Name � Ir ' AGE KJ- <br /> Client ❑ <br /> Sample Location <br /> Sample Type �� <br /> No of `j-� <br /> Number Description bate Time Water Solid , Notes <br /> p Comp Grab Air ContS <br /> r <br /> 84842 <br /> r <br /> f pol!I z - ,� _ r ./ �f 84843 <br /> 84844 ' <br /> r 84845 r <br /> Bet r"q&s ed by (Srgnatur�) y ( egnarure Date/Time <br /> Relrngurshed by (Signature !!5p4ed by (Signalur Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Dale/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment Laboratory Nme <br /> Special Instructions VOAS I 0& METALSJ OTHER I hereby authotizA the performance of the above indicated work <br /> r LGOnO GONDITION •� APPROPRIATE [� Lv � <br /> „FCUNIAINUIS <br />