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C) <br /> j Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvircinmental, Inc. Date 'T -7 3 Page 2 of <br /> 837 Shaw Road - Stockton. California - 95215- (209) 467-1006 - Fax (209) 467-1118 <br /> Client L�\ C���dl er Project Manager <br /> zxmSeer Tests Required <br /> Phone Nu be <br /> cam 1e-, - 1 nQ� <br /> ` Samplers: (Signature) Invoice: <br /> Project Name kkk���'��`�(V��Q �/ 4 �w / AGE VIC <br /> Client <br /> Sample Location Sample Type r <br /> Number Description Date Time Water Air Solid No.Cono Notes <br /> Comp. Grab. <br /> Relinquished y: ( ignature) ecewe y: ignature Date/Time <br /> Relinquished by: (Signature# Received by: (Signature) —V-�, <br /> Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) �; f �� DalaRime <br /> Dispatched by: (Signature) Date/Time Received for b atory Inc Date rime _ <br /> C71 <br /> Method of Shipment: aboratory Nam <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />