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� r � r r r � r r �■r � r r <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. Date ��9� Page __(L 01-5 <br /> 4005 North Wilson Way-Stockton,Calrfomia 95205-(209)467-1006-Fax(209)467-1118 a$� <br /> ClientProject Manager <br /> (./77Ze_­, Tests Required <br /> Phone Number y <br /> Samplers (Signature) Invoice <br /> Project Name yl AGS <br /> Client ❑ <br /> Sample Type <br /> Sample LocationDate Time Solid No of <br /> Number Description Water Air Conts <br /> Comp Grab N z 98040 <br /> 5 255 3► , <br /> 98049 <br /> µ <br /> 9e050 <br /> < <br /> J_ <br /> �3 1 2 98051 <br /> Sg3—3� Q�b� ✓ ✓ ' <br /> � H 98®52 <br /> 98053 <br /> �f 2 98054 <br /> s� <br /> Re rnqur y ( i nature ece v y )gnat e <br /> mLi& r� � <br /> /V 779 <br /> Relinquished by (Signature) ved by (Signal e) 1�' Date[Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dale/Time <br /> Dispatched by (Signature) Dale/Time Received for Laboratory by Daleffime <br /> Method of Shipment / Labora ory N me <br /> Q C� <br /> Special Instructions VOAS B METALS OTHER I hereby authorize the performance of the above Indicated work <br /> GOOD CONDITION APPROPRIATE w <br />