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Advanced <br />GeoEnvironmental, Inc. <br />CHAIN OF CUSTODY RECORD <br />Date 447- cle' Page of <br />OR-L5 <br /> <br />837 Shaw Road - Stockton, California - 95215- (209) 467-1006 - Fax (209) 467-1118 <br /> <br />Client eC ' 2) " "J"•11.-- C ''() - 'WO 'etLJ 4-4-.{..A dAYN&V—S <br />Project Manager <br />I:: / ( ,z,i,--,;::c _ Tests Required <br />Ph Number Saone <br />mplers: (Signature) Invoice: <br />Project Name <br />CC-14; -.-4..26:c*re.A.034 - .7 <br /> <br />..._ <br />/ 6 k i3s <br />\ <br />Sample Location Sample Type <br />No. of / Date Time Time Water Solid <br />Conts. <br />Notes <br />Number Description Comp. Grab. Air <br />MN i - S c c - v i t- <br />. -,..../ ' / <br />M Gc, 1-15 1 3 , L... / N )( <br />H 0-• i — 2 c' 1 1 i ‘-t= ,../ ,./ 7, <br />Z.., 2 1-..) ,. / -.. <br />, <br />. <br />.. <br />la LC: I ---;-1, ,,, ... 1/ ../ <br />Relinquished by: (Signature) Received by: (Signature) <br />-1- 47--- AbfrK (:{ ( <br />Date/Time <br />Relinquished by: (Signature) Received by: (Signature) Date/Time <br />Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Tirne <br />Dispatched by: (Signature) Date/Time Received for Laboratory by: ) <br />. ... Laborato , • <br />7 Date/Time e :: <br />Method of Shipment: / 6) ---- C/%11gLA s-10/17 -e i c E-TnAiita <br />Special Instructions: _ A1 <br />--,i / A / 44 b /..3-71D -z2 <br />I hereby authorize the performance of the above indicated work. <br />......) t, <br />(•