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i Advanced CHAIN F USTODY RECORD <br /> GeclEnvironmental Inc. Z,116-7 Pa / <br /> DatePage <br /> +� 837 Shaw Road - Stockton, California-95215- (209)467-1006- Fax (209)467-1118 <br /> Client �} Z <br /> Project Manager <br /> � 6 Tests Required <br /> Phone Number <br /> Lo1 4on E� <br /> S rs: (Signature) Invoice: <br /> Project Name <br /> AGE <br /> Sample Location Sample Type / Client � <br /> Number Description Date Time Water Solid No. of Notes <br /> Comp. Grab. Air Corns. <br /> 7 S5o k <br /> z A <br /> elmgw)S e y ( ignatur scene y: rgnature <br /> te/Timq <br /> Relinq ished by. (Signature) Received by: (Signature) l/ <br /> at !Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Data/Time <br /> Dispatched by: (Signature) <br /> Dats/Tima Receivetl for Laboratory bfc <br /> Method of Shipment: +(.^ �—^' - J .• .. '� i'� <br /> Lab story me ._ <br /> Special Instructions: <br /> I hereby au7, 7117, - ,/// <br /> ' e tha of the above indicated work. <br /> \ <br />