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Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc Date _2 S-0T Page Z of 5 <br /> 837 Shaw Road- Stockton, California- 95215 - (208) 467-1005- t=ax (209) 467-1118 <br /> Client Project Manager <br /> Tests Required <br /> Pccoj avow <br /> Phone Number , <br /> -zog- q(;7- rOoC. <br /> Samplers (Signatur } Invoice. <br /> Project Name y (�� AGE [4 <br /> ample Type <br /> C]Sample Location <br /> S 'l' b <br /> Number Description ©ate Time comWatecrraa Air Solid ContsNo f ��� Notes <br /> S �3hs l)Z I ?0 ?� x <br /> Witt)(nic is 6 YS S 2gi, IG 2q 3 <br /> uAiA)q6o-,-i5/Z 6SSZ 3 <br /> $d eb Sf 23 06IG 3 <br /> � 51Z5 �SS5 � <br /> 23 o3 <br /> n is e t 7 r�- y ( ignatu starve y (Signature) <br /> Dsts/Tt e <br /> 7"� T <br /> nquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Oate/Fime <br /> Dispatched by (Signature) Date/Time Received for o�0Yory by tef ime <br /> Method of Shipment La atory Name f <br /> C-.CA <br /> Special instructions 1 hereby a�thorize the performance of the above indicated work <br />