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I <br /> • <br /> L <br /> Advanced CHAI F CUSTODY RECORD� <br /> GeoEnvironmental, Inc. Date Page of <br /> 837 Shaw Road- Stockton, California-95215- (209)467-1006- Fax (209)467-1118 1 l 1 r <br /> Client � ' Pro ect Manag l 1 +Tests Required <br /> Phone Number <br /> Samplers (Signature) r Invoice <br /> Project Name60AL� AGE <br /> t/" Client ❑ <br /> Sample Location Solid Sample Type No of <br /> Number Description Date Time Water Air Conts Notes <br /> Comp I Grab <br /> fvJ L JZ10 -I- <br /> 1 <br /> I- <br /> �z�� <br /> GOOD CONT f7 O lrxq T'A <br /> e i ed (Sign re n AINER3_ Date[Time <br /> DECHLO IN LAB 7RESERVED 1N <br /> Relinquished by (Signature) PRESERVA Sign tur { l Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datef ime <br /> Dispatched by (Signature) Date/Time Recel ed L oratory by p DatelTime <br /> r1 ✓vvY� � � Z� l ( jG <br /> Method of Shipment0 T J Laboratory Name <br /> IR <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />