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Advanced CHAIN OF CUSTODY RECORD <br /> Dale '? �, -C, page of <br /> GeoEnvironmental, Inc. �� <br /> :y _G. <br /> � <br /> 837 Shaw Road-Stockton,California-95215•(208)467-1006- Fax(209)467.1118 <br /> Client shwa; i- fZ;s1. �_:L( Project Manager Tests Required <br /> Phone Number <br /> ('Le-1) 41,7—iwL, <br /> Samplers: (Signature) Invoice: <br /> .tom AGE <br /> Project Name Client El <br /> Sample Type <br /> Sample Location No. of/ t / Notes <br /> p Date Time Water Solid 4 <br /> Number Description <br /> � Comp, c .b. Air Corns. � <br /> pj—"� I.L'•eL•1 int lJ.-`3 �'S.'L`= I'LS x 5 f` <br /> -P�'-Ll - S. cle + 15-L.-D <br /> 1422 <br /> Relinquished y: tgnature cerve Y: tgnature Dab ince <br /> Reiinr, fished by. ! ignature)i. Received by: (Signature) DalaRima <br /> Ralirpuished by: (Signature) Received by Mobile laboratory for field analysis:(Signature) Date/Time <br /> i <br /> Dispatched by:(Signature) OMe/Time eiw r rat ry by: ato/T Yne <br /> Laboratory Name <br /> Method of Shipment: Ch'- r,-ft <br /> C vt�-- �dc-e-tJtc;eT <br /> Special Instrucmns: % I hereby authorize the performance of the above indicated work. <br /> $21pt' Fg0 SC0--X i 'tie�TL1 :s alca(1e(f `troiu�� <br /> NoY u,M•'QTa>;-4 AL I At L) �i 't Pl Vg* VZO-41 " A1,1k Was <br />