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( Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc Date1- 03 Page of <br /> 837 Shaw Road - Stockton, California- 95215- (209)467-1006- Fax(209)467-1118 <br /> Client o Project Manager Tests Required <br /> GAJ <br /> Phone Number <br /> 2011_x(67- (� <br /> Sa piers (Sign re) Invoice <br /> Project Name �� AGE <br /> Client ❑ <br /> Sample Location Sample Type No of �O <br /> Date Time Water Solid Nates <br /> Number Description <br /> comp Air Conts <br /> Grab r <br /> MAW 9 IN o621 pq5 2303 JOS-2- <br /> >(X 3 <br /> 7� <br /> UlfA <br /> PSZ3Z s 3 <br /> dos s 7--3k,,31365 <br /> S <br /> r 513 ol IS So � <br /> e 2y { rgnature) starve y (Signature <br /> DatelTIme <br /> e <br /> nquished by (Signature) Received by (Signature) Date(Tlme <br /> Relinqurshed by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datettime <br /> Dispatched by (Signature) Datefrimo Receive r Labor ory by atefrlma <br /> Method of Shipment Laboratory Name <br /> CA I o trt?� � -�- /ecGi <br /> Special knstructrons I hereby authorize the performance of the above indicated work <br />