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� Advanced <br /> CHAT OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date Page --Lot 5 <br /> 837 Shaw Road Stockton, California-95215- (209)467-1006- Fax (209)467-1118 -/ Q 2 Z <br /> Client f P o ct Mafger <br /> j � ,I,�M1 Tests Required <br /> ra U b <br /> P one Nu ber <br /> ti <br /> 1) -//67 <br /> S <br /> v <br /> amplers (Signature) Invoice <br /> Protect Name AGE�J • � � 1 �] L� Client ❑ <br /> Sample Type <br /> Sample Location No of w <br /> Date Time Water Solid Notes <br /> Number Description Comp arab Air Conts <br /> MMA hq-0-2-03 e?-2-6-5 zP1 6 's I ( <br /> ,QA 64-02-0-3 f106 <br /> r <br /> 30 <br /> e inqa �Slgn tura Received y (Signature) Date[Time <br /> Relinquished by ( ignature) Received by (Signature) Datef ime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment Labora ame <br /> Special Instructionsi� V I hereby nze tf gL v-'. IV-- <br /> he rf rmance of a above indicated work <br /> [( <br /> r <br /> /t Iv b ✓ <br />