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( Advanced CHAIN OF CUSTODY RECORD <br /> GeoEnyironmental, Inc. _ „ Q �1.5 Date T Z Page of—L- <br /> 837 Shaw Road - Stockton, California 95215-(209)467 1006- Fax j209)467 1119 <br /> Client Q u, k, K I��� Lc.r Project Manager 1�M Tests Required <br /> i`t ck&l <br /> Phone Number <br /> 07- Y6 7 -- /004- <br /> Sample (Signature) ��� Invoice <br /> Project Name AGE <br /> Client ❑ <br /> Sample Location Date Time Sa Type Solid No of Q�� `v <br /> Number Description Water Air Cants Notes <br /> Comp (arab <br /> '►'71,x/ D8�7�z $�7.C7z 1242 r r <br /> 1333 <br /> SE VAT ON <br /> _Z� <br /> GOO CONDF oN �A$WtWTB <br /> DEC ItIIYA IN IN <br /> e e i tura ecerve y rgnelvre t)ata/Trme <br /> Qo <br /> quIshed by (Signature) Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Reeer or Laborat y a""Time <br /> Method of Shipment Lab satory flame <br /> Special Instructions I herebythorize the <br /> a performance of the above Indicated work <br /> i <br />