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( <br /> • CHAIN OF CUSTODY ECORD <br /> Advanced <br /> GeoEnvironmental, Inc. Date Page Z- of Z- <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467 1006-Fax(209)467-1118 <br /> Client 75 Protect Manager Tests Required <br /> �� <br /> Phone Number <br /> �t <br /> Sampi s (Signature) Invoice <br /> AGE a <br /> i Protect Name /o � � �jClient ❑ <br /> Sample Location Date Time Sample Type Solid No of Notes <br /> Number Description Water Air Cants <br /> Comp arab � <br /> � �Z� 7as42 <br /> s- <br /> ��r �sas' E <br /> 70843 <br /> y <br /> t <br /> 70844 <br /> 70845 <br /> Mw S/oc2-W) 611 a� 12 Lx <br /> R61 in e y )Signature Received by (Signature) Date/Time <br /> she (Sig Lure Received by (Signature) DatafTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatetTime <br /> Dispatched by (Signature) Date/Time Received or Laboratory b& Date/Time <br /> Method of Shipment Laboratory Name <br /> dAir- <br /> Special <br /> cSpecial Instructions i.Eales OTHER I hereby uthorize t e performance of the above Indicated work <br /> PRESERVATIQGOOD CONDITION VAPROPRIATE <br />