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( Advanced CHAIN OF CUSTOD RECORD <br /> GeciEnvironmental, Inc. Date 3 L 6t Page of Z <br /> 837 Shaw Road- Stockton, California- 95215- (209) 467-1006 - Fax (209) 467-1118 0 <br /> Client 1 la{O'kyl'��er � ManagI l�( Tests Required <br /> Pone N�u -16 7-1 <br /> Samplers (Signature) y �� Invoice <br /> Protect Name AGE d I t CJ1P �►�'� �� `1, eC. Client E <br /> Sample Location Sample Type No of f 'Q <br /> Date Time Water Solid N Notes <br /> Number Description Comp Grab Air COr1tS <br /> AZAR - - (n7v -51-31W 11L-17 K <br /> x X A <br /> 'w I I ZA Lu\Q �-2-k- V 1A k" <br /> w rzQ Z Lqo( <br /> e inq i y gnature) Receive y gnature) D te/Trm <br /> -t o4 6 <br /> Relinquished by (Signature) N Received by (Signalure) DatelTr e <br /> Relinquished by (Signatura) Received by Mobile Laboratory for field analysis (Signature) [ � Daterrime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date[Tima <br /> CY <br /> Method of Shipment dfatory Name <br /> CCJ <br /> _Zr --- CG-L lc�Ll-\- <br /> Special Instructions �( f �� I hereby authorize the performance of the above indicated work <br />