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CHAIN OF CUSTODY RECO <br /> nR4Advanced Date bPage o+ <br /> GeclEnvircinmental, Inc. <br /> -837 Shaw Road-Stockton,California- 95215 - (209) 467.1006- Fax (208)467-1118 rn <br /> Project Manager f I ' Tests Required <br /> Client e-5 5 <br /> Phone Number �i ' <br /> N <br /> L <br /> Samplers: (Siggature) v Invoice: <br /> a <br /> AGE � Q; <br /> �� y7 loom ❑ <br /> Project Name P-7 6, <br /> Sample Type No. of 9�yr Nees <br /> Sample Location Date Time Water Solid <br /> Number DescriptionCor11s. <br /> Comp. Grab. Air <br /> g <br /> 5._ 5- z7 0l 17! t` I �6W <br /> 7ol /7/-2- J 1 <br /> 1,zT `i �,'/6 m <br /> I ✓ ) (il <br /> as �� <br /> in <br /> r ��. <br /> IT <br /> F � <br /> Z <br /> 05 36 `�127Gr1 17/3`21, t/ J <br /> J5� --;5 �7 U/ Oe !Time <br /> G"Ned y: <br /> ehnq a 9nature) <br /> ✓JC� - Dete/ilme <br /> Roti qurshad : (Signalwe) fleceived by: (Signature) ✓ ,J <br /> DelelTime <br /> Relinquished y:(Signature) Received by Mobile Laboratory for lield enalyoia:(Slgnature) <br /> DateyTims <br /> DateRime Received for Laboratory by: <br /> Dispatched by: (Signature) <br /> T <br /> Laboratory Name n _� D <br /> Mottled of Shipment: 40e, G <br /> FT <br /> I hereby orixe TS�r nog of the above Indicated walk. <br /> a <br /> Special Inotrucneru: <br /> 6////tA.Jf�i/'u- u <br />