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i Advanced CHAIN OF CUSTODY RECORD <br />GeclEnvironmental, Inc. <br />Date L 19 9 page 3 of <br />4005 North Wilson Way -Stockton, California - 95205 - (209) 467-1006 -Fax (209) 467-1118 <br />z Pl%&e <br />Client Uttirc.t Sam ,� ��� Project Manager G Tests Required <br />Phone Number <br />Samplers: (Signature) ,Vb Invoice: <br />Project Name e AGE [R <br />t ,`�v <br />�[wgdeA-t CL►�vHo���- M Client F-1 <br />Sample Location Sample TypeDate Time WSolid No. of <br />Water , <br />Number Description Air Conts. ' e, <br />Comp. Grab. <br />- <br />a-Io.S' c/th`I ILie c' <br />t 150 <br />— —lox X— <br />(6 <br />(b r s' 113 X I X x <br />C' 11to n I x l; .1519 <br />t <br />i-Z'1�,5� layo X I k i 1213 <br />t _ � <br />e m is a Ig lure) e ed by:(Signature)_ — Dat /Time <br />Relinquishe by: (Signature) eived by: Si ature) Date/Time <br />Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br />Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br />Method of Shipment: Jf�� Laboratory Name // <br />✓ •i r vt r� 1 p `'� I c �C- CQ w. / v C' <br />Special Instructions: VOAS O8G '1ICIAW OTNER I hereby authorize the per anc o the above Indicated work. <br />GOOD CONDITION-11L „ APPROPRIATE <br />