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1 _ 71 773 7771 771 7—'1 <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental Inc. <br /> : .. „' Date Page of <br /> 4005 North Wilson Way-Stockton,Califomia-95205 (209)467-1006-Fax(209)467-1118 <br /> Client Project Manag r <br /> Tests Required <br /> Ph a Number <br /> S : (Si nature} X Invoice: <br /> Project Name AGE W <br /> Sample Location Sample Type — <br /> Client <br /> Number Description Date Time Water Solid No. of ' <br /> Comp, arab. Air Conts. r 464.42 <br /> 1� 4fiA9 <br /> .443 <br /> A16 x x 464. 4. 41 <br /> VJ <br /> 46445.. <br /> 4 s 46446 ' <br /> 4.644 <br /> MOO � � �l�0 1 o X ; <br /> 46448 <br /> e inquis a : ( r ature <br /> starve y: ignature <br /> DaEe/Tlme <br /> Relinquished y: (Signature) Received by,• (Signature) <br /> Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) <br /> Date/Time <br /> Dispatched by: (Signature) Date/T€me <br /> Received for Laboratory by; <br /> Data/Time <br /> Method of Shipment: <br /> Lab rat y <br /> Special Instruction: <br /> I hereby authori the erformance of the above indicated work. <br />