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Advanced CHAIN OF CUSTOD RECORD <br /> Dateg-11-1-J13 Page of <br /> GeciEnvironmental, Inc. <br /> 837 Shaw Road Stockton, California- 95215- (209)467-1006-Fax (209)467-1118 �} -] <br /> Client f Pro'ect Manager / Tests Required <br /> I 1i KJ, , ;,� <br /> Phone Number <br /> Wc,-7 1600 a <br /> Samplers: (Signature) Invoice: <br /> AGE <br /> Project Name0-1i Client-F5- <br /> ,L) CA 0 <br /> Sample Location Sample Type No. of J�` <br /> Date Time Water Solid Notes <br /> Number Description comp. crab. Air Corns. <br /> �1)63 MZ <br /> • o 0 <br /> ` r !lo �¢ ! <br /> r <br /> daa u L <br /> elin-- is a y: nature aee ve y: ignatura Date/Time <br /> 01"Re inquished by: (Signature) Received by: (Signature) Dale[Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) DatelTime <br /> Dispatched by: (Signatur /t r � DatafTime Received for Laboratory Date/Time � <br /> Method of Shipment: <br /> Special instructions: ,i ��p�� %/ aby authorize the perf mance of the above indicated work.. I <br />