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t Advanced ' CHAS OF CUSTODY RECORD <br /> "- FEB � � Date �- Page --i of <br /> GeoEnvironmental, Inc. <br /> 837 Shaw Road -Stockton,California-95215-(209)467-1006- Fax (209)467-1118 <br /> Client f *ana <br /> Tests Required <br /> P one Number <br /> SAM S. T fe) Invoice- <br /> Project Name AGE ] <br /> Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Alr Solid Co o of Notes <br /> Comp (arab <br /> 1ZY <br /> 11-7/65 <br /> ZZ 0 <br /> e mqu� y ig at a ece e y gnature atelTime <br /> Rehn is d by (Sign re) Rec a (Si n�tu a le/Time <br /> 7-114S <br /> ftehngWshed by ( nature) Re obile Laboratory for field analysis (Signature) batelTime <br /> Dispatched by (Signature) DatelTime Received or Laboratory by �,1ty <br /> Data/Time <br /> Method of Shipment Labors Name <br /> I U <br /> " t ' <br /> Special Instructions 1 hereby aut ris the perfo ance of the above indicated work <br /> fltitil� l� ti sllllllll� anrrr! aaaa� aaaaaa ..rrr. <br />