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t <br /> CHAIN OF CUSTODAECORD <br /> Advanced <br /> _== Date-k-4 Inc �Z� Page �— <br /> 837 Shaw Road- Stockton, California-95215 - (209)467 1006- Fax (209)467-1118 j 2 <br /> Project Manage <br /> Client G`l � � n �" CL Tests Required <br /> P one N tsar <br /> zoo r // <br /> Samplers (Signature) Invoice <br /> AGE W <br /> Project Name ` ~���---�- i � Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water S olid No of Notes <br /> Number Description Comp Grab Air ContsXXX Y <br /> i <br /> 60,j el 6 'X Y X, <br /> oqo X Y� <br /> Relinquished b i ature ecewe y ignature Date Ime <br /> �z i2 0 6 3a <br /> Relinq fished by (S nature) Received by (Signature) Date/Tim <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Tlme <br /> Dispatched by (Signature) Datoffime Received for Laboratory by Date/Time <br /> -t -I <br /> Method of Shipment Labor ry Name l ff <br /> Special instructions ������ r���� I hereby authorize the perlormanco of the above indicated work <br />