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t� <br />Advanced <br />GeoEnvironmental, Inc. <br />837 Shaw Road - Stockton, California - 95215 - (209) 467-1006 - Fax (2- <br />09) 467-1118 <br />CHAIN OF CUSTODY RECORD <br />Date 40-, Page of <br />04.0 2-? <br />ClientProject <br />b f e ct� <br />�.$(� — 351S <br />Manager <br />Tests Required <br />Rgc'l'P► <br />Nv*' <br />Phone Number <br />s��.x�-oma cls <br />95ai9 <br />�`ao�- 1116-7- <br />aac� <br />Samplers: (Signature) <br />Invoice: <br />Project Name ; <br />� art <br />&aS <br />,Ie <br />AGE ❑ <br />Client <br />` <br />n , <br />Sample Location <br />Number Description <br />Date <br />Sam ; ype <br />Time Water Solid <br />Air <br />No. of <br />Cor>ts. <br />Notes <br />comp. <br />crab. <br />DSQ - 1 <br />4-11-03 <br />i20.3 <br />X <br />X <br />JAI <br />se- 7- <br />1 <br />1115-7 <br />USQ-3 <br />1153 <br />PL -4 <br />t 5. <br />DSQ-7 <br />tZ%(P <br />_..r <br />e y: ( ignature) <br />.000e'Viffi <br />ecerve y: <br />Date/T)me <br />Received by: (Signature) <br />Date/Time <br />nquis ed by: (Signature) <br />Relinquished by: (Signature) <br />Received by Mobile Laboratory for field analysis: (Signature) <br />Date/Time <br />Dispatched by: (Signature) <br />Date/Time7Received <br />for Laboratory by: <br />Date/Time <br />5- J3 0, <br />Method of Shipment: <br />laboratory N me <br />Te <br />,,y, <br />CA c <br />Special structions: <br />'Se <br />I herebyauthorize the performance pf the above indicated work. <br />el'P s to., <br />I& <br />- Le <br />53 C.- `t11z 104 ELA..)c6er Av4t C 9502 <br />