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Advanced CHAIN OF CUSTODY RECORD <br /> Of <br /> GeciEnvironmental, Inc. L ,., Date Page <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(20 467-1118 <br /> ClientProject Manager <br /> 11 r f Tests Required <br /> Phone N mber <br /> y <br /> Samplers: (Signature) e: <br /> Project Name` ods AGE Client'❑ <br /> Sample Location same a ype No. of <br /> Number Description Date Time Water Air Solid Conts, Notes <br /> Comp. (arab. <br /> Lf a(� o <br /> V, 13D] <br /> Re ' s a y: ig ure Received y: gnatureDatelTime <br /> 5 p5--R-oo 0 <br /> Raltnqui r <br /> d by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Re i a for-Laboratory by: Date/Time <br /> 5 lC(u <br /> Method of Shipment: Laboratory Na <br /> L r t 71 <br /> Special Instructions: ' I hereby authorize the perfo mance of the above Indicated w <br /> 1w ifififfiffif <br /> s <br /> f <br />