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i <br /> ( Advanced CHAIN 4F CUSTODY RECORD <br /> GeoEnyij onmental lnr 0 1 () I&l Date Page Of f _ <br /> 837 Shaw Road- Stockton, California 95215 - (209) 467-1006 - Fax (P09) 467-1118 <br /> Chant Projet Manager f <br /> f d Tests Required <br /> P one qumber <br /> /7 <br /> Projsc f Name _ Sam rs {SI talars} � Invoice <br /> �1 � <br /> AGE <br /> Client <br /> sample Location Sample Type <br /> Number Description <br /> Date TIIne WaterA€{ Solid C o St Notes <br /> Camp drab <br /> GOOD CONDIT ON-1ZAPPR DPRIATs <br /> HE,\.DSPACE A SP-NT CONTAINERS <br /> --10-91UIUNAT I.AS <br /> pRIs9ERVA7I WAS O&G METALS I OTHER <br /> —Re iinga+is aSign r ece ve y igna uro <br /> e/Trnr <br /> Rehnq++lshed by {Signature} Received by (Signature) Date/Time <br /> Rehngr+ished by (Signature) Received by Mobile laboratory for field analysis (Signature) DateJTime <br /> O+spOatajTime <br /> at,lied by (Signature) Ric v abarataryray <br /> l� Da /Time _ <br /> Method of Shipment <br /> Laboratory e <br /> Special instructions 1 hereby t rize th erf ma ce of the above indicated work <br />