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l- l- illlllllllllllll1 l- llllllllllllllll' Illllllllllll♦ illllllll- I_ ll- i_ il_ il_ fiiiiiiiiiiiii tiiiiiiiiiiiii f� I <br /> Advanced CHAIN OF CUSTOD RECORD <br /> Date 0 VQ10Y page of <br /> GeciEnvironmental, Inc. 7 a o C <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax 9)467-1118 <br /> Project Man��ac�er F Tests Required <br /> Client Oes lf.,r✓i� fir• ! / H1 iC, 4 <br /> Pho a Num er <br /> Samplers (Signature) �� Invoice, <br /> Pro ect Name ' Jas^ AGE/ <br /> l 4�Z f c/ Peep r I e S �'°':0 � Client ❑ <br /> Sample Type , <br /> Sample Location No of ®� � Notes <br /> Date Time Water Solid <br /> Number Description Comp Grab Air Conts (ry <br /> l <br /> W-11A � �s 44146 <br /> --� <br /> 44147 <br /> ,w-ZSR -?,D' Ip ;gp <br /> W-11A i 25' /0 /5 44148 <br /> V� � � �?Ol0 <br /> 1l ' 1 <br /> 44149 <br /> ' <br /> 44150 <br /> 44151 <br /> 44152 <br /> mquis ed by (Signature) Received by (Signature) _ Date/Time <br /> Rei quashed by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboralo by Date/Time <br /> g 3 <br /> Method of ShipmentVO� Gq f, Lab tory Name � � <br /> C-'S-Q '40eS^i�Aaffl �304 <br /> Special instructions Zq —!! <br /> l hereby authorize the performance of the above Indicated work <br /> Gn ��i ititf L — f <br />