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j Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date %7-49 —03 Page i_ of <br /> TD <br /> 837 Shaw Road - Stockton, California - 95215- (209) 467-1006- Fax (209) 467-1118 <br /> Client Pro'ect Manager Tis Required <br /> Phone Number <br /> o - 9(.,r7- /OOG <br /> .�c <br /> Sampl rs: ignature) y ,ed Invoice: <br /> Project Name AGE U. <br /> S.:'Aro V) er Client ❑ <br /> Sample Location Sam ype � k <br /> Date Time Water Air Solid Cv�1ts Z Notes <br /> Number Description � <br /> Comp. Grab. <br /> IIoiz-i�lo3 dLv3 <br /> Z � �K <br /> W; <br /> ICE(! ®� <br /> [3QO Ci7NDEEPAABS rt CONTA <br /> NT ERS <br /> ';PACE <br /> f' IN <br /> DEC ILORNATED1. <br /> RECD SEAt_ED &INTACT VIA CIS� n a t+� ajx <br /> e+ u +gn lure) ace Fye T FT T9rgna FURro Date/Tl e <br /> quished by: (Signature) Received by: (Signature) l)atelTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date rime <br /> Dispatched by: (Signature) Detelrime Recelved for aboratory m�i" ---~ WWI e <br /> Method of Shipment: I oratory Nams <br /> ca-1 ver 1 A- mwie <br /> Special Instructions: i hereby authorize the perfo mance of the above indicated work. <br />