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Advanced CHAiN OFb Page � <br /> CUSTODY EC RD <br /> GeoEnvironmental, Inc Date <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006 - Fax (209) 467-1118 On Q� <br /> Client Pr �e M ag Tests Required <br /> Pone Number <br /> as { ature) Invoice <br /> Project Name AGE <br /> 1 Client EDPro <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conte Notes <br /> p Comp Grab <br /> -NAjf r <br /> Be,n u e y ( Knal ecerve y rgnature Date[Timjeu7V <br /> Relmq ,shed b S Received by (Signature) Data(T,me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Date/T,me Received for Laboratory by /) X T,m <br /> / Datele <br /> Dispatched by (Signature) /V�J\ �/ 04 <br /> Method of Shipment Laboratory NaV '� T-ft� <br /> IT A <br /> Special Instructions I hereby suth zs t performance of the above indicated work <br />