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i � � � � fid � � � � i � � � tttti• lti• ti t� i_ <br /> Advanced CHAIN OF CUSTODY RECORD <br /> _--- %'� GeciEnvirgnriental, Inc Date '� Page _ ��� <br /> 837 Shaw Road Stockton, California- 96215- (2 )467 1006 - Fax (209)467-1118 <br /> Client 4 Project Moag r Tests Required <br /> r <br /> 6 <br /> Z <br /> Number <br /> aOk <br /> Sam rs (Si nature) Invoice <br /> w <br /> Project Name �� AGf= ❑/ <br /> Client ❑ <br /> Sample Location Sample Type r <br /> Date Time Water Solid No of Notes <br /> Number Description Water <br /> (arab Air Conts <br /> � <br /> Roll s e ykuign tura ace ve 9n D e[Time <br /> i f f1 f <br /> Reli quashed by (Signature) calved by (Signature) Date ime 6�4 <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dateffime <br /> Dispatched by (Signature) i Dateffime Received for Laboratory by Date/Time <br /> Method of Shipment LaboratNa <br /> or e <br /> Special Instructions t hereby authorize the pagotmance of the above indicated work <br /> iJ.fir fo ( pll �� <br />