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Advanced <br /> CHAIN OF USTOORECORD <br /> GeciEnvironmental, Inc _ _ Date FLU <br /> Of <br /> 837 Shaw Road- Stockton, California 95215- (209) 467-1006 Fax (209)467-1118 <br /> Client Project Nianager <br /> Tests Required <br /> P one umber ' <br /> ate <br /> 004,- <br /> 5amp ers (Signature) Invoice <br /> Project Name g AGE <br /> } <br /> �l 4l 4 t+ Y'tJ i,� Client ❑ <br /> Sample Location Sample Type ' ,�/ <br /> Date Time Water Solid s` Y Nates <br /> Number Description Comp Grab 111r Conts <br /> Na of <br /> r <br /> 7*/ !p 2- ^�4 <br /> �� JC <br /> AF1JUr -111 <br /> r,r,rr�nri a , <br /> L <br /> Re inq ns a ig lure ecerve y ignature <br /> D ""lime7 .P-z <br /> Relinquished by (Signature) Received by (Signature) f fDaterT;me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) (� Date/Time <br /> �-Y <br /> Dispatched by (Signature) Date/Time Received for Laboratory by ' D e/Time <br /> YIN I _VC� <br /> Method of Shipment � Laboratory Nam �/ <br /> Special instructions 1 hereby uth nze the rformance of the above indicated work <br /> (�o Oue'�M�lV6.4 - <br />