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j Advanced <br /> CHAIN OF CUSTODAECORD <br /> -== GeciEnvironmental, Inc. Date-J'e-Z7 Page Of <br /> 837 Shaw Road-Stockton, California- 95215- (209)487-1008 - Fax (209)487-1118 <br /> Client L o� t Project Manager <br /> J L,1. C- Project <br /> Tests Required <br /> Phone Number <br /> Aa'� <br /> Samplers (Signature) Invoice <br /> Project Name AGE <br /> Cl <br /> ien ❑ <br /> Sample Location Sample Type No of <br /> D Date Time Water Sohd Notes <br /> Number Description Comp Grab Air Corps <br /> � 1 J go <br /> tom- Svc ��.� �� � ' � ✓ � <br /> Fie ori is y ignatur Received byJ91linature) OatelTime <br /> Relinquished 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 Received for Labor by Date/Time <br /> 12- 19-a+ <br /> Method of Shipment 1r� laboratory Name r <br /> b�ti� L Y <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />