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Advanced CHAIN OF CUSTODY RECC <br /> GcoEnvironmental, Inc.- Date q;- "qI6 Page <br /> of hrn7frerrt [:ulrforniu <br /> 1803 4Resi Marrft Lane, Suite A- Stockton.California-9"207-(209)qLS 0254• Fax(209)9560700 <br /> Client int Project Manager <br /> T=s Required <br /> `D011 Phone Number <br /> to Samplers: (Signature) lttypic <br /> 4Z _Q <br /> Project Name tN � `�' 7 LCXx r <br /> 114 <br /> /%'` AGE <br /> Client <br /> Sample Loc:atlonsamplo Type. i <br /> Number Description Date Time Water Air Solid !v <br /> Qom ° <br /> otes <br /> comp. <br /> w <br /> w <br /> U <br /> iTel�-nyu.shed by; ;S�g ij[uLcl Peceived by. ignature Da i <br /> y . <br /> �4 <br /> 1 <br /> f4 etin uished b Si natwc <br /> ,i G Y� i S ) Received by: (Signature) D3te(Tlme <br /> Fa <br /> w Refinquished by: (Signatusc) Received by Mobile Laboratory for field analysis: {signature) pate/Tune <br /> 7 <br /> 'D Dispatched by: (Signature) 17atel7irne fieceivocl f Laboratoty by: date rime <br /> ! <br /> Method of Shipment: Labvrat y Name <br /> Kactfhw <br /> <r Special instructions: I horeby atitthoiize the apt/errlormance of the above indloaled worl <br />