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! ! i <br /> t Advanced CHAIN OF CUSTODY RECORD <br /> - GeciEnvtl unniental, Inc 0 31OG f pate 1`2 tt; 6 3 Page [ of � <br /> 837 Shaw Road Stockton, California 95215 - (209) 467 1006 - Fax (209) 467 1118 <br /> Client 0 t!1 C'J Pro ect Manager <br /> Tests Required <br /> _ Pha a Num4pr <br /> 2p c� Lt G 7 -IOC-)6 <br /> — Samplers (Signature) V Invoice <br /> Project Name <br /> �— <br /> CLI l �- C ��V�n� clie t ❑ <br /> Sample ` Location Sample Type No of <br /> Number Descriptioif Date Time _ Water Air Solid Con <br /> Notes <br /> r _ comp Grab <br /> lW 14 <br /> it -7 0CLSO <br /> r <br /> kW Ids 1>< X14 l ' (E to�e ?� X <br /> e inqu s ed by fSkmniaturl!) �--' - ecTt eWe a y T§Fgnalure Data(Tim <br /> V 10 a3 bD0 <br /> RehnjUAqhed b ignatul Reserved by (Signature) DalelT e <br /> Goon corrntTloN �iRdPRSATf3 <br /> HE 1/ <br /> Rel1rQ8tM9IAIk1i A?wfttf4,NB PRESERVED rNLAH Received by Mobile Laboratory for field analysts (Signature) Date True <br /> VO O&G METAI S O1tIF1[ <br /> Dispatched by (Signa patelTime Re r La oratory by <br /> � 0��" <br /> 5;�-cx) <br /> Method of Shipment Laboratory Name /(J97 <br /> C CA C)Q e�YA(Cj - - (HE'D SEALED & INTACT VIA 11-4Q—�OYMN111 Akc c <br /> Special Instructions �� -15: <br /> �- <br /> P q lL 1r P EDF r/ I hereby authorize the performs ee of the above indicated work <br />