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1 <br /> AF 0 <br /> Advanced 0 a CHAIN OF CUSTODY RECORD <br /> ( <br /> GeoEnvironmental Inc. <br /> Date d -J i 62 Page of � <br /> 837 Shaw Road- Stockton, California- 95215- (209)487-1006- Fax (209)487-1118 <br /> Client © Project Manager, eq <br /> Tests Required <br /> P ne Nry^ur <br /> Sal;tplers:I(Signal ) Invoice: <br /> Project Name AGEF '�YV� nL�l G Ott _ Client EJ <br /> Sample Location Sample Type No. of f� <br /> Number Description Date Time Water Air Solid Conts. Notes <br /> Camp. Grab. , <br /> i< <br /> \7-X <br /> D'V� <br /> G D CC NDITION 1PRIAT. <br /> ('113 X".,7 I NT- CONTVNE�­�_Z <br /> • 4.L:.w-: .:..x.11 LLJ 'i «J <br /> ean. e ( a ur ace gnat DatetTime <br /> Relin ished by: We) Received by: (Signature) r� -�� Date rime <br /> Relinquished by- (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received tot Laboratory by. Date/Time <br /> \ <br /> Method of Shipment: Laboratory Y Name 4 <br /> Special instructions: I hereby au raze the perform& a ck the above Indicated work. <br /> i � w <br /> 100'er PPCI 'P+�Aol SaG�� i�'�aG` V1 q' f L OY,t 2Gtr :f �_DC/PA �'Ir Ir�� <br />