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( _ Advanced CHAIN OF CUSTODtii <br /> RECORD <br /> Inc.GeciEnvironmental,=� Dace page —�L of <br /> 837 Shaw Road- Stockton,California-95215- (208)467-1006 - Fax(209)467.1118 <br /> Client o it Project Manager <br /> -IF.V%A Cit .l�a.hr Tests Required <br /> Phone Number <br /> LU'1, LJL- 7 -1 b Uc> <br /> O "V <br /> Protect Name <br /> Samplers (Signature) cr.� '1� � Invoice� ,(� � <br /> G,i��S r L4.C-6 c C�." � v's '' AGE <br /> ❑ <br /> Sample Location Sample Type Client�, . <br /> Number Description Date Time Water Solid No of o� <br /> Comp Grab Air ContS Notes <br /> t,.pra--lo (:PT, Z fin` 2-�- n <br /> C�'�'2-- �l�i hzRZ. l l rM f <br /> � � 1-0-Ht5OO X <br /> a <br /> C 2 go tt 1( f la z-L-01 1635 X C <br /> e in uis e y Mignat a eceiva <br /> y ignature <br /> Irk <br /> �5T� Date/Time <br /> Relinquished by (Sr lure) Received by (Signature) I 1 01'�Dat.ffi . <br /> Relinquished by (Signature) Reserved by Mobiia Laboratory fpr fie#d analysis (Signature) <br /> Date/Time <br /> Dispatched by (Signature) Date11 ime Recelved for[ago ratory b <br /> DaterNme <br /> Method of Shipment <br /> C -.L L ratory <br />' <br /> Special instructions <br /> # hereby authorize the performance of the above indicated work <br />