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• <br /> Advanced CHAIN OF CUSTODOECORD '"`- <br /> GeciEnvironmental, Inc. <br /> Date `rte Page of ' <br /> of Northern California <br /> 1803 West March Lane,Suite A-Stockton,California-95207-(209)9560264-Fax(209)956-0700 "�3"15 XA ESE 3Q� <br /> Client, Grn C �� Project Manager �� Nc Tests Required <br /> f r <br /> Phone Number qq / <br /> Samplers: (Signature) 1 Invoice: <br /> AGE <br /> Project Name t � 7r�rir ��� '� Clie t p <br /> Sample Type <br /> Sample Location Solid No. of _ Notr <br /> Date Time r _----' <br /> Number Description Wate Conts. �' +� ... :"� ."' K: ' <br /> Num l7 Comp. Grab. AIC 1 <br /> 17 W5 <br /> y 1 y } <br /> rl <br /> Mv 1 7 l3 � � .�'�k'�q.� 'iu-,r n. Via' � '�'•''"� <br /> X I U 7 <br /> Fix - <br /> Iy��FI/ w f `.✓ .,`'"•..� ,�' ` f��V � .'� '� i r�`��a Cr`r8V V FG.L+f n�-�-ati <br /> X\mw sl <br /> r ,r <br /> J— q ...�r r� j '��t-r�Fv� <br /> "A J(J id <br /> Relinquished ylure eceeyignature Datef me <br /> TV <br /> Relinquished by: (Signature) Received by: (Signature) Date/Time <br /> p l6 � ��a ►o:3v <br /> Relinquished by: (Signature) IR elved by Mobile Laboratory for field analysis:(Signature) <br /> Date/Time Received for Laboratory by., <br /> tit" t <br /> Dispatched by: (Signature) Y <br /> Method of Shipment: Q� 1 , VD0 a Laboratory Name MCC <br /> `CT <br /> Special Instructions: trfllkt" flp/� �,KA� OrRpry I hereby authorize the pe r ante of the ova Indicated work. <br /> YUriJ UOIU MALS OTHE <br /> GOOD OONDITIO'N ✓ APPROPRIATE <br /> i <br />