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Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date Page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> Phone Number <br /> "'Oa - X40- 10c) 6 <br /> Samplers: (Signature) �'` Invoice: <br /> Project Name A 4 -A y-t- ��tyf,u� �/'(,/Jlj,-l't" ; AGE <br /> Client r <br /> Sample Location Sample Type , - <br /> of <br /> Number Description Date Time Water Solid No.Conts. <br /> �� Notes <br /> Comp. Grab. Air <br /> P I�— 5 P'pfo t f,s <ks�v , y ') r`/49 �o.0g y <br /> 10. 19 X X <br /> e inquis a y: (bi net Received by: (Signature) <br /> DaletTime <br /> Iw�t � 3-�J-9915: 30 <br /> Relinquished by: (Signature) Received by: (Signature) -Date <br /> /Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/rime <br /> Method of Shipment: Laboratory Name <br /> Special Instructions: I hereby authorize the performance of the above Indicated work. <br />