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} <br /> Advanced CHAIN OF CUSTODY RECORD ` <br /> - GeoEnvironmental, Inc. Date R-5-dS Page -3 of 3 <br /> 637 Shaw Road- Stockton,California-95215- 209)467.1006- Fax(209)467-1119 <br /> Client I,5LX,00i vl S�uxu t 1 Project ManageraR,equired <br /> Phone Number <br /> (zoobl-toc <br /> Samplers: (Signature) e: <br /> K- <br /> ProjectName �jBt vG- Siu'�t l ❑ <br /> Sample Location Date Time Sample Type Solid No.of <br /> Number Description Comp. drab. Air <br /> Corns. <br /> �- ►3-10 $-3 l0 �-S'oS 12rv'1 X I <br /> 4-13- tS 15 1305 X <br /> d-lL1-S 8-� @ 5 i428 t l <br /> t3-14-tD <br /> to, 1433 <br /> t3-hk-15 '' 15l tk5� <br /> Ix <br /> a mgws a Y: ignatura eca ve y: (Signature) <br /> Dale ime <br /> -5-�5 b D <br /> alinquish by: (Signature) Received by:(Signalure) Da /Time <br /> Relinquished by: (Signature) Received by Mobilo Laboratory for field analysis:(Signature) •"rr r,T I 1 Oare(Tima <br /> Dispatched by:(Signature) Darefrinno Rpreived for aboratory IN ..J Dahl <br /> Method of Shipment: L oratory Name <br /> CAL- OJ�I�� �' �7EGEf <br /> Special Instructions: 1 hereby authorize the performance of the above Indicated work. <br />