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( Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc, Date 'A � Page 1n_ <br /> 837 Shaw Road- Stockton, California- 95215 - (209)467-1006- Fax (249)467-1118 <br /> Client ',y P,R Project ager Tests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name /f {/ Y .�s AGE '4 <br /> Client [] <br /> Sample Location <br /> Sample Type No of ' <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab <br /> - i pR F__ 5'��r VIP- ' eR 1 Ntf <br /> F1 lo'Al <br /> eI adh gnature igrsat �� Date/Time <br /> J � <br /> Rel i5 <br /> a Sig lure) Received by ignature) DateJ7ime <br /> Reiinq ish ign e) t. Received by Mobile Laboratory for field analysis (Signature) Datef ime <br /> Dispatched by (Signature) Dateffime IRC7for Laboratory y Date/Time <br /> Method of Shipment Laboratory Mame <br /> Special Instructions i hereby authorize the performance of the above Indicated work <br />