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CHAIN OF CUSTODY RECORD <br /> Advanced Date oFyzP��-'�1 Page j of <br /> ' GeoEnvironmental, Inc. t- a <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client IProject Manager <br /> PAAL— <br /> aP• o Tests Required <br /> P one Number <br /> lers Sig ature) Invoice: <br /> Project Name e)��" j�..pl�( ��' AGE <br /> I (- <br /> Client [' <br /> Sample Location w Sample Type No. or <br /> Number Description Date Time Water Air Solid Conts. / 60009 <br /> Comp. Grab. �j� <br /> 60010 <br /> .� OIL �T' � uL-�t2..�r 7�� 1� l � � N 6.0011 <br /> ��� ►a L � .�L 1�=(t �! / X 1< N 60012 _ <br /> 60013 <br /> 4W--02,112-101 `�`� `!1ru,JST IG L4 LL I I�4S /` <br /> 60014 <br /> qu gnalure) eceive y: (Signature) <br /> 1()2- 1Z--re( /2 d <br /> - <br /> Reli quished ignature) Received by: (Signature) <br /> j . <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> tibispatched by: (Signature) Date/Time Received for Laboralor�y: c D to/Time , <br /> Vo <br /> Method of Shipment' <br /> J Laboratory Name <br /> C a L rAE7A1S OTHEIT rvtC(-fh•l/r t'RIS a - <br /> Special Instructions: 1 heraby_Authoriz he performance of the above indicated work. <br /> GOOD CONDITION OPR!ATE <br /> ____— <br />