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CHAIN OF CUSTODY RECORD <br /> Advanced Date Page of--�L <br /> GeciEnvironmental, Inc. <br /> CO2) 837 Shaw Road-Stockton,California - 95215- ,209)467-1006 - Fax (209)467-1118 <br /> ClientProject M (QW- <br /> VV—ei'� Tests Required <br /> — 4 <br /> T to! <br /> Phone Number <br /> Samplers: (Signature)A, j Invoice: <br /> A <br /> Project Name Client <br /> r 4w A/I <br /> Location <br /> Sample Type No of <br /> Sample Date Time Solid No. <br /> Number Description Comp. Grab. Corns. ' <br /> .Xg-14 <br /> L <br /> 'a Inquil I ure ecelve y1S-1Q—na—tu-,eF <br /> Relinquished by: (Signature) Received by: Si( gnature) 1 , Date/Time <br /> Relinquished (Signature) Received by Mobile Laboratory for field analysis: (Signature) Dale rime <br /> I <br /> DatData/Time ... Laboratory by: —0-i'171m. <br /> Dispatched by: (signature) i 7 <br /> Method of Shipment: QPX) Laboratory Notes <br /> I hare6y authorize the performance of the above indicated work. <br /> Special Instructions: <br />