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Advanced <br />GeoEnvironmental, Inc. <br />CHAIN OF CUSTODY RECORD <br />Date ("( <br /> Page ._..— - of 75 <br />837 Shaw Road - Stockton, California - 95215 - (209) 467-1006 - Fax (209) 467-1118 <br />Client( 01:171 t,-‘-__-(tt.,----(2 .--.,--iAt-' Asatec • (e. \ Project Manager , <br />Tests Required <br />Phone Number <br />Samplers: (Signature) Invoice: <br />Project Name (3 Ivi -,7- <br />V \ AGE ,I19 <br />,.....„,, „ y ..„.. <br />N. Client II <br />- Sample Location Sample Type <br />No. of • <br />Number Des cription Date Time Water Solid Notes <br />Comp. Grab. Air , Conts. <br />c... 7) _ ,. 0,, / <br />...,/ N y <br />X1 <br />AALQ,-Zi:i ., ei::. fir': <br />X X <br />._ <br />.1..)- <br />1\i‘O---.1-,7) . •, <br />i ( 2-'- X <br />tAv4 -).3 -- 3z) ! I 3:% <br />I )( <br />Relinquiped by: (Signaturrl , <br />0:,aPI 1 ' - ' -a_ . <br />Received by: (Signature) <br />ND-4"AI <br />_. Date/Time <br />Relinquished by: (Signature) Received by: (Signature) Data/lime <br />Date/Time Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br />Dispatched by: (Signature) Date/Time Received for Laborato by: t, Date/Time i <br />Method of Shipment: <br />tAilaitkjtall.-1-- <br /> <br />ratory Name - __ , '. <br />-. (161 I Tec 6 F--,k,ILI,K)---/) <br />Special Instructions: I hereby authorize the performance of th• above indicated work. <br />li&R-1.1,_ , <br />,