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M IMI MM IM M <br /> CHAIN OF CUSTODACORD <br /> Advanced <br /> Date L' �L" � � Page of <br /> GeoEnviron mental, Inc. <br /> 4005 North Wilson Way-Stockton California 95205-(209)467 1006 Fax(209)467,1118 <br /> Client <br /> P7e1LAL- <br /> Phone <br /> c <br /> t Mranager <br /> Tests Required <br /> a Number <br /> 16Y 7 a (" tDok <br /> Samplers (Signature) h ,yX Invoice <br /> Project Name A�\ `Vcl 7 b6)Iti_I 4 Z �� Client ❑ <br /> Sample Type I ' <br /> Sample Location Date Time Water Solid No of , ` �' x 63682 I <br /> Number Description Comp Grab Alr Conts <br /> s <br /> 63683 <br /> , <br /> NW_7 SOIL s ki��sr-s ' 63684 <br /> 53685 <br /> r44,. <br /> 63686 <br /> TILW-.5" -Tf.!i- 1+ X i- <br /> r }� �( y� {, 63687 <br /> �V-- - ' Itl' 2 63688 <br /> I <br /> e+ is gnl a eceive y ignature <br /> DatelTi <br /> Relinquished by (Signature) Received by (Signature) <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DalelTime <br /> Date/Time Received lot Laboratory by - Date/Time <br /> Dispatched by (Signature) 1 <br /> Laboratory Name <br /> Method of Shipment C. (!� �4(,�i lt <br /> �r 1/ 4 <br /> Special Instructions tJ i1' VOAS 0$G METALS OTHER I hereb �orrze th� �e\rlormance of the above Indicated work <br /> GOOD CONDITION APPROPRIATE !f <br />