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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnvironmentai, Inc. Date 4'19-03 Page t of <br /> 837 Shaw Road -Stockton, California- 95215-(209)467-1006- Fax (209)467-1118 <br /> Client C� �O't A Project Manager i <br /> I Q 1 Tests Required <br /> Phone Number <br /> 20— yLP7— /()( G <br /> Samplers (Signature) � Invoice <br /> Project Name C� AGE <br /> Client ❑ <br /> Sample Location Sampl Solid Pe No of �� 4 <br /> Number Description Date Time Water Air Cohrs 'V Notes <br /> Comp Grab <br /> /�W J a <br /> VW oqm 03 Ito 0 / <br /> Vwphloa 03 <br /> 01 /09a 03 I� <br /> Re[ q ( Jgnature) Receivedy ignature Date/Time <br /> 3 <br /> 9 X03 1('30 <br /> nquishe by (Signature Received by (Signature) <br /> Date(Tkme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Dateffime Received for Laboratory by - DatelTime <br /> O` <br /> Method of Shipment Laboratory me O <br /> �a ver n t � C a <br /> Special Instructions I hereby authorize the performance of the above Indicated work <br />