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l <br /> Advanced CHAIN OF CUSTODY RECORD <br /> " GeoEnvironmental, Inc. Date 10'l2-oy Page 2 of 2- <br /> 837 <br /> B37 Shaw Road-Stockton, California- 95215-(209)467-1006 - Fax (209) 467-1118 -710 <br /> Client G Project Manager <br /> to arcio` Tests Required <br /> VCAVI^- <br /> Phone Number <br /> (s Oct, qIs.-7 — C)co <br /> Samplers: (Signature) Invoice: <br /> Project Name alt" VQ� I m, %/yJ� !//J-� EMati�t,� AGE [ <br /> si 1 �b �O �7C Client <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No. of a��!( K� Notes <br /> p Comp. Grab. Air ContS. IL <br /> L) — SS 'Qo�rw, � Io-IZ 13coo x � X X X <br /> X >< X <br /> WIZ <br /> 4s- ts ge�,� ID-I-L <br /> V) <br /> Relinquished by: ISi at a ecowe y: ignature Date/Time <br /> Relinquishey: (Si n ure <br /> 9 ) Received by: (Signature) tom— Daternme <br /> vrJ`— <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Tfine <br /> Dispatched by: (Signature) Date[Time Received for Laboratory byte Date/Time <br /> f 10_ -D uo <br /> Method of Shipment: Lastory Name61-1 <br /> Y 2ftil 4 <br /> Special Instructions: 1 hereby authorize the performance of the above indicated work. <br />