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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmental, Inc. 2!v 0 Date 31 Page ��_ <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006- Fax(209)467-1118 <br /> Client f Project Ma ger Tests Required <br /> &Ae� <br /> Phone Number <br /> q(a /� • <br /> S p rs (Signature) Invoice <br /> Project Namee <br /> r060 , <br /> � s I AGE ef <br /> ,�`�e Client ❑ <br /> Sample Location Sa le Type <br /> Date Time Water Solid No of Notes <br /> Number Description comp Grab Air Conts <br /> i <br /> rro m� 54 b8795 <br /> " - q.6 68796 <br /> .r kw 3 -a 5 I; <br /> YJ 98 797 <br /> 68798 <br /> a nulona reReceived y gnature <br /> D a/1'Ime <br /> j=a <br /> A-C4 /111' - M,/1". . ., 1ALSOTHER e Y6 <br /> Rellnwahed by (Signa ure) Receivj p(S Lure) PRESERVATION <br /> alerrime <br /> Relinquished by (Signature) Receiv Coo q�[��ry tat ti ,q y Ignatu ) Date/Time <br /> j Dispatched by (signature) rriikklHiUU Date/Time kkIlYY tt Received for Laboratory by / Date/Time <br /> Method of Shipment a oratory Nam <br /> Special Instructions ]� I hereby authorize the pert rmance of the above Indicated work <br /> Ced1 c�� 1 <br />