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CHAIN OF CUSTODY RECORD <br /> ( Advanced - � <br /> __-- GeoEnvironmental, Inc. Dace - `� Page —� <br /> 837 Shaw Road-Stockton, California-95215 - (209)467-1006- Fax (209) 467-1118 <br /> ClientElk <br /> , Pro a nager <br /> -K7f it VA ; t L Tests Required <br /> XPe umber <br /> &77 �t <br /> Sam (Signature) Invoice <br /> Project Name AGE <br /> Client ❑ <br /> , <br /> Sample Location Sample Type <br /> Date Time No of <br /> Number Description Water Solid Notes <br /> Comp Grab Air Conts /� \ <br /> 91-2310 NO f� <br /> it la <br /> fr 1 'y X <br /> e n is ( gn turel starve y ignature D to rms <br /> R hngwshed by (Signature)-./ Received by (Signature) I Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dateffime <br /> Dispatched by (Signature) DatelTtme Recervod for La r t by Da Dime <br /> Method of Shipment 'Laboratory Na e <br /> Special instructions 1 hereby author ze the p ria*mance of the above indicated work <br />