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r r� rr r r � r r � i■r r r it r � � � � rr. <br /> Advanced <br /> CHAIN OF CUSTODOECORD <br /> j JT1/6 � <br /> of <br /> GeciEnvironmental, Inc. Die Page - <br /> 837 Shaw Road Stockton, California - 95215 - (209)467-1006 - Fax (209) 467-1119 0 0-'9 <br /> Client Project tanager r Tests Required <br /> Phone Number <br /> M 71. <br /> - <br /> Samplers: (Signature) � Invoice: <br /> 7C AG E <br /> Project Name �� /� ` Client ❑ <br /> Sam p le Location Sample Type No. of a`� /� Notes <br /> Date Time Water Solid <br /> Number Description Air Conts. <br /> Comp. Grab. ' <br /> Date/Tim <br /> alure Received y: ignalure � ' G <br /> woe inquis ) <br /> Relinquished by: ( ignature) Received by: (Signature) Data/Ti e <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Dateffime Received for Laboratory by: 2 -2-W C} Da2- teTi <br /> Laborat name <br /> Method of Shipment: <br /> a I( ell � r CC <br /> Special Instructions: '\ �fl l hereby authorize the performance of the above indicat d work. <br /> 7 <br />