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Advanced <br />GeoEnvironmental, Inc. <br />CHAIN OF CUSTODY riECOR:D <br />Date ---/u C3 Page 3 of .3 <br />837 Shaw Road - Stockton, California - 95215 - (209) 467-1006- Fax (209) 467-1118 <br />0 Lr› <br />Client <br />•E I L --C 0 Nui (., --yy,e, io <br />Project Manager <br />Tests Required , cx....„. (>(--1-7y,....,_; <br />Phone Num / 7 <br />(a-C',C21 q b 7 -/674-.) <br />Samplers: (Signature)L. ^ Invoice: :) <br />Project Name ( 4.) <br />4). <br />u Client L <br />Sample Location <br />Description <br />) <br />Samle N(N i <br />No. of V <br />Number Date Time Water <br />G <br />p <br />rab.TypeAir <br />Solid Notes <br />Comp Conts. <br />61S i 01-0—i)doi (0 -101) 2,0-0 I I !, <br />tA, ' <br />f, ,----/ 2— 35-- <br />ci <br />_. ' f 2-Y0 4 [6( <br />..; \ 3 60 trU,. - <br />Relinquished Relinquished by: (Signatur,, Received by: (Signature) <br />— <br />. Date/Time <br />Date/Time Reli -quished by: (Signature) Received by: (Signature)71, <br />Date/Time Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br />Dispatched by: (Signature) Date/Time Received for Laboratory • ,.. i Date/Time <br />ojk•It) 1 ' <br />Method of Shipment: , I oratory <br />. <br />a " . D5 ei (/— <br />Special Instructions: I hereby authorize the performance of the above indicated work. <br />..----- <br />- -