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� Advanced <br /> CHAIN OF CUSTOD%ECORD <br /> 121 � � <br /> GeciEnvironmental, Inc. Date z a� Page of <br /> 637 Shaw Road Stockton, California- 85215- (208)467-1006-Fax (209)467-1116 4 t <br /> Client r�` �,�-� ��- Project Mikna <br /> Tests Required <br /> - <br /> hone�N� ber <br /> Samplers (Signature �� Invoice. <br /> �L. ❑ <br /> Protect NameAGE <br /> Aw <br /> , Ghent ❑ <br /> Sample Type +' <br /> Sample Location Date Time Water Solid No of � Notes <br /> Description Comp Grab hr Cont$ <br /> E`1i <br /> Relinquished y ' ire ece va y igna(ure Do elrim <br /> 111 ` 2Z 03 {600 <br /> Relinquished by (Signature) Received by (Signature) Date/rl ne <br /> Relinquished by (Signature) Received by Mobiie Laboratory for field analysis (8ignoturs) Date/time <br /> Dispatched by (Signature) Datellime Receive o L orato by Do /Time _ <br /> G [� <br /> Method of Shipment Laboratory Noma <br /> Ca we r 1�i GA ec k <br /> Special Inatructiona�kl�) R � � <br /> I hereby authorize the performance of th bove Indicated work <br /> i1�1 <br />