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t <br /> CHAIN OF CUSTODY RECORD <br /> Advanced <br /> GeciEnvironmental, Inc. Date `� °� Paye of <br /> 4005 Notch Wilson Way-Stockton,Caltfomia-95205-(209)467-1006-Fax(209)467-1118 <br /> ClientPro M Hager <br /> S' Tests Req <br /> uir d <br /> P e umber <br /> (Si azure) Invoice <br /> AGE <br /> Project Name <br /> Chem ❑ <br /> Sample Location Date Time Sample Type Solid No of Notes <br /> Number Description Water Air Conts <br /> Comp Grab <br /> 1.1 <br /> 07-94-00 -3 11 <br /> D -3 <br /> i <br /> euis e y (Si <br /> nature ec rve y t ure Date/Time <br /> Rel quts a by Received by (Signa r DatelTtme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysts (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by f VDate/Time <br /> Method of Shtpme Laboratory N� e <br /> Special Instructions I hereby au horize t e e mance (h bove indicated work <br />