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Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date 1 Page 7 of <br /> of'Northern California <br /> 18D3 West March Lane, Suite A-Stockton, California-95207-(209)956-0264-Fax(209)95"700 <br /> Project Manager <br /> Client � �r ,-�.� �7 � Tests Required <br /> �J <br /> Phone Number <br /> A <br /> Samplers:. (Signature) 1 Invoice: <br /> Project gameV AGE <br /> r 'ek'p 1 , i ? ��( 1 Y Client <br /> Sample Sample Type r ' <br /> p Location No. of /C} r <br /> Number Description Date Time Water Solid ! • Ali ,1 560 60 <br /> p comp. Grab. Air COIItS. ,I <br /> i <br /> 56061 <br /> - - . ✓A 56062 <br /> r <br /> 3 ✓ ,� 56063 <br /> 56064 <br /> 56065 <br /> —'] It t r <br /> elinquished by: (Signature) RSelure I _ DatolTime <br /> A)o,e--L 7 4v <br /> Relinquished by: (Signature) i4eceived by: (Signature) — J <br /> k f <br /> Relinquished by: (Signature) Received by Mobile Laboratory for Geld analysis: (Signature) I 56066 <br /> i <br /> Dispatched by: (Signature) Datellime Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> Special Instructions: 1 hereby authorize the performance o the above indicated work. <br /> I j/ 4 <br />