Laserfiche WebLink
( Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc Date 700 Page oto_ <br /> 4005 North Wilson Way-Stockton,Cahfomia-95205-(209)467-1006-Fax(209)467 1118 <br /> Client - Lan e, Protect Manager <br /> IM �a� Tests Required <br /> LA'Phone Number <br /> ALOV?' <br /> Samplers (Signature) Invoice <br /> Project Name AGE Ryt Client ❑ <br /> i <br /> Sample Location Sample TypeDate Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> -40 x I 1 <br /> AA w� - -S•UO I s X 1 X x x X <br /> lin LJ- 3 10 6 .6- <br /> M w3 <br /> M W - -6-00 � 15- <br /> AA <br /> nn w q x X1 >(I <br /> AAw3- 55" 6-� Qv 35" X X x - I <br /> e inque y ( ignature Receivedy (Signature) ate(Time <br /> STS sd�r <br /> Rehrnquished by (Signature) Received by (Signature) C rn -CJCf� �('f/bn�I DatelTime <br /> �� ��Q <br /> Relinquished b (Signature) �n(iQ" rnie f d f e- <br /> q y ( 9 ) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DateJ me <br /> C Ind 14� 6-QED 1 10 PM <br /> Method of Shipment Laboratory Name <br /> CA ovcc 10 IQL11 C45+I-e <br /> Special Instructions I hereby authorize the perform nce of the above indicated worts <br />