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Advanced <br />GeoEnvironmental, Inc. <br />837 Shaw Road - Stockton, California - 95215 - (209) 467-1006 - Fax (209) 467-1118 <br />ere by authorize the per ormance or In. a ove inoicatea worK. <br />CHAIN OF CUSTODY RECORD <br />Date 1--7-6, - 7- Page 2— of 7- • <br />Client wy,, Project Manager <br />Wil/4 C i 6k___ a c , Tests Required <br />Phone Numbir . <br />Samplers: (Signature) , Invoice: <br />Project Name (2.) , ay. / <br />. AGE IZ <br />7:—?---, Client L <br />Sample Location Sample Type " No of <br />Number Date Time Water Solid A Notes <br />Description Comp. Grab. Air I Conts. <br />Bi -So 1031 A 1 R i.-- D <br />G i -5S too X I A X <br />X A <br />:LS -4 113 2- <br />_ <br />Rel. quiihed by: ( i ature) Received by: (Signature) DatefTime <br />7- -=7..- -1- / i-S-Oc, <br />C T. il ---"F Date/Time Relinquished by: (Signature) Received by: (Signature) <br />Date/Time Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br />Dispatched by: (Signature) Date/Time Received for Laboratory/61r .., , <br />tjt \...._,_,A.----. <br />Date/Time <br />7- 2 ..!. •-=`-' ' .:.,: c. b <br />Method of Shipment: ept_a_. rs <br />A ' <br />let6in I 14+'* 0 <br /> <br />Lai:Kip( Name / <br /> <br />' ree.k. <br />. . . . . .. . . . <br />Special Instructions: