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Advanced CHAIN OF CUSTQDY ECORD <br /> Ge0EV vaonmental, 1nC Date ll t� page of <br /> 837 Shaw Road - Stockton, California- 95255 - (209)467 1006 - Fax (209)467-11118 <br /> Gilent .—• <br /> Project Manager <br /> Ue4�e : <br /> .(� rests Required <br /> icy,r-(,( <br /> Phone Number <br /> am ers { ignaturej Invoice <br /> Project Name .� AGE Q' <br /> _ _�.K- _ _ _��LG Ghent <br /> ZC0' <br /> Sample Location Sample Type No of <br /> Number Description Fate Time Water Air Solid Gonts Notes <br /> Comp Grab <br /> 11 -20--C,3 <br /> " I'd , - i -2c) <br /> eTinq—I d Fi - ( ) FF.ceive y ignatu e D tefrlma <br /> c) <br /> Relinquished by (S�gnature s Received by (Signature) DatefTrme <br /> Relinquished[�I� ?1XWZN CQNTPAWERS erved by Mobile Laboratory for field anelyars (Signature) DeteJTrme <br /> ALCHLNArEI)IN LAB PRESERVED <br /> Dispatched tjRES� IICJN &0 1�4STALS DatelTime Re r or Laboratory / lefrlme <br /> I'I <br /> Method of Shipment ��I Vrer/?� Laboratory Name <br /> RECD SEALED&INTACT VIA Vl L IL'I <br /> I---- <br /> Special InstructionsAA I hereby a rite the er ormance of the above fndwated work <br /> `11-11 '75 <br />