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Advanced CHAIN OF CUSTODY ECORD <br /> Date I I,Z Pae __�_ of <br /> GeciEnvironmental, Inc. <br /> 4005 North Wilson Way-Stockton,California 95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager Tests Required <br /> ACiFic. FJK�Lk <br /> Phone Number <br /> OGI ` 9 o- <br /> Samplers (Signature) Invoice <br /> AGE <br /> Project Name `� Client <br /> C \k)8 Lfl� <br /> Sample e w <br /> Sample Location Date Time Wa ep Yp Solid Na of <br /> Number Description comp Grab Air Conts Notes <br /> 14nNi^rorinG 1n,ei1 RAS5 <br /> M -35 s ' <br /> M\)35- Vo <br /> Y% h 11 It le <br /> 55 <br /> 11 /r r I <br /> a .� �. X <br /> M 6— �5 " \1 �� of C 1 ff 0 ,OS <br /> J \, i , , <br /> M _ MOrll-#aPlA) Vf-' b <br /> 5 <br /> b - 2�' q <br /> 7e, i nqus e y (Signature) ecerve y ,gnalure �^�De 2�atte/Time <br /> rF (T ! -'7� <br /> Relinquished by (SlignatureF Received by (Signature) DalelT,me <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Re eived f r Laborator Date(Time <br /> =;K�4 <br /> Method of Shipment Laboralory N ]e <br /> Special Instructions 1 hereby authorrize the performance of the above Indicated work <br />