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t Advanced <br /> CHAIN OF CUSTO*ECORD <br /> -_- GeciEnvironmental, Inc 2 02-q'-- (Ic, Date Page __L_ of� <br /> 4005 North Wilson Way-Stockton,California-95205 (209)467-1006-Fax(209]467-1118 <br /> Client Project Manager 17 <br /> -7�g4 L:�e & Tests Required <br /> C <br /> Phone Number <br /> Samplers (Signature) �j Invoice <br /> Project Name AGE <br /> Client ❑ <br /> Sample Type � <br /> Sample Location Date TimeWater Solid No of Notes <br /> Number Description Air Cants <br /> Comp Grab <br /> ve ","X <br /> u7- <br /> e in ui e ( nat ) ecei y (Signature) <br /> DatelTime <br /> Refr quashed by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) gateffirne <br /> MT , �-A0 S3O <br /> Dispatched by (Signature) Datef ime Received for Laborator by i Datamme <br /> Method of Shipment Laborat6fy Name <br /> WAS QU I;iEThSA Q i aria <br /> Speaai Instructions 1l E� �r";" R " I hereby authorize the pe ormance or the above Indicated work <br /> fr <br /> IOD SPALL AB.0 -- DG In1�+Elia r <br />