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CHAIN OF CUSTODY RECORD <br /> Advanced <br /> GeoEnvironmental, Inc. Dace Page of <br /> 837 Shaw Road Stockton, California- 95215 - (209)467-1006- Fax (209)467-1118 <br /> a b L� <br /> Client Project Manager Tests Required <br /> Phone Number (� <br /> Samplers: (Signature) Invoice: <br /> AGE <br /> Project Name i 4A—,r f Client <br /> Sample Type No. of "� <br /> Sample Location Date Time Water Solid Nates <br /> Number Description comp. Grab. Air Conts. <br /> i <br /> pi <br /> it <br /> Relinquish y: ign ure <br /> Received y: (Signature) Dale/Tim <br /> ,. o <br /> Da#elTimo <br /> Relingwshed by: (S hat re) Received by: (Signature) t <br /> Oats/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature} <br /> r�Date/Time ecaive for aboralo .°�t�i <br /> me <br /> Dispatched by: (Signature) Gi J <br /> Labofator me <br /> Method of Shipment: <br /> i <br /> I hereby auth ize the performance of �Sbove ed work. Ri <br /> Special Instructions: <br /> I <br />