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Advanced / CHAIN OF CUSTODY RECORD <br /> Date ' -2 5- Page ) of y <br /> GeciEnvironmental, Inc. <br /> `> <br /> 637 Shaw Road-Stockton, California- 95275 - (209)467-7006 - Fax (209)467-1718 <br /> Pro ect Manager <br /> Client L izY Tests Required <br /> Cy}(GLvt� <br /> Phone umber <br /> ' G-)-too <br /> Samplers: (Signature)�jT t. Irnrolce' <br /> w AGER <br /> Project Name FF p � �v Client <br /> Sample Type <br /> Sample Location Date Time No. of �q`�t+s' Notes <br /> rn <br /> Number Description Water Air Solid Cos. <br /> p Camp. Grab. t <br /> V_ 1� 09, X x 'x <br /> V-3 )D(b X r X <br /> V -5 « ss X 1 X <br /> V <br /> i j i'i X t X X <br /> V_7+ �Zz X I x • <br /> elfin s e y: 1 1 tuts ecerve y: ignature Dad(Tima <br /> �C/tet. -zr -�ld3s <br /> Dete(rime <br /> Relinquished by: (Signature) Received by: (signature) f� Tr A <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) .`.) Date/Time <br /> Dispatched by: (Signature) DaternmecaivedAo La <br /> boratory by:.� Da�b(Tima <br /> Laboratory Name <br /> Method of Shipment: <br /> , t hereby authorize the performance of the above indicated work. <br /> Special Instructions: <br />