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Advanced <br />GeoEnvironmental, Inc. <br />CHAIN OF CUSTODY RECORD <br />Date 41' 7-44=--- Page ( of <br />837 Shaw Road- Stockton, California • 95215 - (209) 467-1006 • Fax (209) 467-1118 <br />Client FC00i c•-s-v‘ ..S Co 1\ . 110 ,1 (.....t vs. - Cr -1- 'NJ C. i <br />Project Manager <br />Ck-.--, (-.N \ lc ("- , . Tests Required <br />Phone Number / ,/, <br />20,1 ‘--iU/ i 00(- /'" /L/ <br />Samplers; (Signature) .( / Invoice: <br />Project Name ----- <br />.4:r (., kiQ <br />L7 IA <br />AGE <br />t1/47 Client E <br />Sample Location Sample ype <br />No. of <br />Number Date Time Water Solid Notes A. Description Comp. Grab. Air Coats. A7 <br />ST • 1 /6 0 7pL,. \ sir. cc.,.."14_,,- ....„,.,,e, t 4 .7_01; I L.) ! %)--- <br />- <br />, <br />n .n, • .•ji)y. (st atixt...._..",.........._ . <br />_,. <br />- __--- <br />Received by: (Signature) <br />g.a fi:er -to A iroa„....in. CI 1 .S1%1. it' r <br />r c• I" otk . e ". <br />c-0:- tert14.1r.t . S %.c-it ) <br />Dateftime <br />11- 7-a.,/ IL, 3 , <br />Date/Time quished by: (Signature) <br />ir <br />Received by: (Signature) <br />Dateffime Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br />Dispatched by: (Signature) Date/Time , .. Received for Laboratory by: ")........C., <br />I s.: <br />Date/Tim!' <br />..4 - 1, t.: t. <br />Method of Shipment: <br />C I <br />,./ te• ^ , 1,,.., r <br />Laborathry Name .. <br />Li 1 <br />Special Instructions:/.- <br />—r‘•4 e-- wksi le_ <br />I here y authgrize the performance of the above indicated work. <br />,--.--&--=:- ... lUo 6F