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i �i i i i i � t• �s � wig t11sa� sa�� <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date Z- Page <br /> 837 Shaw Road -Stockton, California-95215- (209)467 1006- Fax(209) 467-1118 � J .�04 <br /> ClientProject ager <br /> � L.4� Vii✓ Tests Required <br /> Phone Number <br /> 6Ct1 C Sampt ;(Signature) Involoo. <br /> AGE <br /> Project Name Z,Az,.l <br /> s ClientSample Location Sample Type Solid No of <br /> Number Description Date Time Water Air Corns Notes <br /> Comp Grab <br /> e mq e y ignature e—c eTv–eT5 TStgnatu—re F Da"' 'me <br /> Re fished 15V (Sign ure) Received by (Signature) DatelTime <br /> r ti <br /> r <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> i <br /> Dispatched by (Signature) DateFTime Recelvedfol bo,r _rat bye _ / r f A,t� Date/Time <br /> Method of Shipment Laborato me <br /> Spatial tristtuctions I here y a ize the perfortipaiLco of the above indicated work <br /> I <br />