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� � i � � � ■t■ ■111■1 f, tf� �■■ �� tt, tt�� �� <br /> CHAIN OF CUSTODY RECORD <br /> j Advanced <br /> GeoEnv>lronmental, Inc. Date � �� �z Page L �, � 1 <br /> 837 Shaw Road- Stockton, California-95215- (209) 467-1006- Fax (209)467-1118 <br /> Client project Manager Tests Required <br /> vrnl I G <br /> Phone Number f <br /> Samplers (Signature) Invoice <br /> AGE '?�J_ <br /> Project Name ze <br /> Client ❑ <br /> Sample Type f <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> 88984 <br /> 88905 <br /> z d�Z.34� 1 13y� <br /> 88966 <br /> ''OV&G +t SALS OTHER <br /> Acc —A <br /> n1 <br /> SPACE ABSENT T C0605 <br /> e mqu y ignature ecewe y ignature Data/Time <br /> i <br /> Raj fished Signatur Received by (Signature) �� Date[Time <br /> Relinquished by (Signature) Received by Mobi to Laboratory for flaid analysis (Signature) Date/Time <br /> i <br /> Dispatched by (Signature) Datefrime Recelved for Laboratory by D ime <br /> Method of Shipment Laboratory me <br /> I hereby authorize the performance of the above Indicated work <br /> Spacial Instructions <br />