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( Advanced CHAIN OF CUSTODY RECORD <br /> of <br /> GeoEnvironmental, Inc. Dp`Z(`� ��� Date oG 2 2 Page —L— <br /> 837 Shaw Road-Stockton, California-95215- (249) 467-1006- Fax 1209)467-1118 <br /> Client Project Manager Tests Required <br /> Phone Number <br /> (2oq) 417 - /aaf� ��,�10 <br /> b b3 Samplers: (Signatu e) 1 Invoice: <br /> AGE� <br /> Project Name 11 >,�%,��of Clienf ❑� '�`�� <br /> - x <br /> � <br /> Sample Location Date Time No. of � � Notes <br /> Number Description WatSample Type er Air Solid Corns. <br /> Comp. Grab. <br /> MW oGZWZ 116I4z, 3 F, <br /> a6 26oz /ZSR K 4 <br /> Oil P38 <br /> s ��Z �z Jza� <br /> Jz3 J X � <br /> Relinquished y: cery <br /> (Signature) ae y: gnature t]ate/Tima <br /> Relinquished by: (Signature) Received by: (Signature) DitetTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis.(Signature) � ,}""r' Qato/Tima <br /> Dispatched by: (Signature) Data/Time Re for Laboratory <br /> �i�V CVr� <br /> Method of Shipment: Labor ary Name <br /> M., Cet <br /> Special instructions: I hereby uth ize t e performance of the above Indicated work. <br /> r <br />