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( Advanced CHAIN OF CUSTODY RECORD <br /> --- GeoEnvironmental, Znc. Date -� -rro Page of <br /> 4005 North Wilson Way-Stockton,Califomia-95205.(208)467-1006-Fax(209)467-1118 <br /> Client � ,� f Project Manager <br /> r U LLA,? Tests Required <br /> Phone Number <br /> _ — (zori <br /> Samplers: (Signature) �`� `h ,�r <br /> /� Invoice; <br /> Project NameIA- (�JL F ((>tl-f f � � � �'tr � AGE [0'. <br /> Client ❑ <br /> Sample Location Sample Type K) <br /> Number Description Date Time Water Solid No, of L Notes <br /> L <br /> Camp. Grab. Air Conts. <br /> C�.' r� -l5-c� I!' � ?� �C �( 45.28 - - <br /> f�ti�3 .45.283 ._ <br /> E,,� �� ' _�.--� I2 <br /> X- x k - <br /> t <br /> --._4628...... <br /> 0 13'65 x 1 kX � � 45286 <br /> k <br /> I <br /> ingL�s ( natesReceived y: (Signature) <br /> I` bate/Ti m ee <br /> Relinquished by: (signature) Received by: (Signature) <br /> Date/Time <br /> 0 <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory <br /> Date/Time <br /> Method of Shipment: Labora cry Name <br /> Special Instructions: <br /> 1 f A� J <br /> VOAS I hereby authorize thQ perform nce of the above indicated work. <br /> ICE/toOCG i�IE�R!-S OTHER j \� <br /> CION)CONDITION <br /> CQNTafIVERS __ <br />