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t Advanced // CHAT CUSTODY RECORD' <br /> GeciEnvironmental, Inc. 69 F/ I <br /> Date727/63 Page __ I Of <br /> 837 Shaw Road-Stockton, California- 95215- (209)467-1006 - Fax (209)467-1118 <br /> Client protest M na er <br /> 6� C Tests Required <br /> Ppone N tuber <br /> to <br /> San (signature) Invoice <br /> Protect Name AGE 7 - <br /> iC Client ❑ <br /> Sample !Description <br /> ocation Sample Type s <br /> Number <br /> Date Time Water Air Solid No C ntst Notes <br /> Comp Grab <br /> S710 <br /> .pit+ <br /> eXq ! y tgnature eceive y gna(ure Q e/Time <br /> Reby (Srgnatur4o- ) <br /> Received by (Signature) <br /> i <br /> atelTime <br /> Ret nquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) Date(Time Re ve for Laboratory by <br /> l)a /Tlme <br /> Method of Shipment L <br /> aborNem <br /> o" LA,I— <br /> Special trlructlD uthorize thrformanca of the above Indicated work <br /> Cao��r <br />