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..�. .� .me � tttttttttttti ti!■ir t� � � � � � � � � � <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnyironmental, Inc. 7 a- Date Z o Page J of4_ <br /> 837 Shaw Road Stocklon,California- 95215 - (209) 467-1006 - Fax (209) 467-1118 <br /> Client ,.._. } Protect Manager <br /> Tests Required <br /> Phone Number <br /> Z_rd i w. <br /> Samplers (Signature) U �J Invoice <br /> Protect Name 1 ' AGEf <br /> `( Client <br /> Samplb Location Sample Typ <br /> [late Time Water Solid No of <br /> Number DescriptionDate <br /> Grab Air Conis ( B6096 <br /> v r e 90.i <br /> 88097 <br /> X 6098 <br /> ze � + r� �, _ a 86099 <br /> 86100 <br /> 86101 <br /> e mn u s y tgn ra y eta vd by gnature <br /> Date/T)tne <br /> RelinquWfRedby (S3 ureJ Received by (Signature) r " <br /> Bell ad b nature DNT,111. t / 86102 <br /> PPIy ) PP- lei MON ' r4(3b j'1A bile Laboraiury for Held iied <br /> (Signature) <br /> D+s tc_e a' r"( i� CturTe� f't r+ It i tt / Date/Time or-i,aboratary y <br /> i}f1;Lt rii,Zil1_ _� ��i��l��iYCf1J / 7 <� Date�Tima <br /> I iu ' �onvI <br /> Method of Shipment ' Laboratory Name <br /> eclat insituctions I hereby aut or a the perlormance of the above indicated work <br /> I � <br />