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� <br /> CHAIN OF CUSTODY*CORD <br /> Advanced <br /> Date-7-1 Page _ ofJ_ <br /> - - GeoEnvironmental, Inc <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467 1006-Fax(209)467-1118 <br /> Client ( /Ati Df R,I �/3+ Project Manarvokp�4 <br /> r <br /> V Tests Required <br /> n <br /> I <br /> Phone Number <br /> 01 0 - � A <br /> Samplers (Signature) Invoice <br /> AGFA <br /> Protect Name CALr V Client ❑\\ <br /> r � <br /> Sample Location Sample Type No of <br /> Date Time Water Solid ry Notes <br /> Number Description Comp Grab Air Conts �Q t6 <br /> bu 2'I V'^ !�) y ��j�'l8 1i5� �RRsS <br /> Co f.£fJ a 73�c <br /> I <br /> shzy <br /> go <br /> 0 , <br /> I �$J �� i, , <br /> Q o �C <br /> • n .• D tE � i <br /> t� rr rr <br /> 11"00 <br /> J7mqui e y rgn re) Receivedy ignature DatelTime <br /> ,1STgNtoA0 - 6-0 5 3o <br /> Relinquir/dr(Signature Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Dale(rrme <br /> Dispatched by (Signature) Date/Time JRrw�efor Labor ry by e <br /> Date/Tim <br /> .7, 7- S <br /> Method of Shipment Laboratory Name <br /> CA OUEIL.iitarL i A lg_ ddb�;C_V1 <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />