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(liiiiiiiw ww w w w w w wilt i ti l• � ti i• t• tw 1♦ tw <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date �/ V/ Page of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager <br /> Tests Required <br /> Phone Number <br /> Sampi rs. (Signature) Invoice. <br /> Project Name � `� v � / / [� AGE <br /> Client ❑ <br /> Sample Location Sample Type No of , <br /> Date me Water Solid , <br /> Number Description Date Comp Grab Air Conts i 69952 <br /> {� <br /> KOJ/ ellY/,d/ �.�� >C 6 9 9 5 3 <br /> -V' 69954 <br /> Z D C}J 1366' f� <br /> f <br /> 69955 <br /> 69956 <br /> V t�c1 /3 � r � � 01 lam .� � <br /> 69957 <br /> li <br /> 00"60a&1lRecelved�l/ /t 1o.s� �� 6995® <br /> e lnqu y ig ursy gnature <br /> Rehnqu shed by ISI,ffiaturaj Received by (Signature) DatelTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTirne <br /> Dispatched by (Signature) OatelTime Received for Laboratory Date/Time <br /> � �o���� <br /> ` f <br /> I <br /> Method of Shipmerjol Laboratory Name <br /> C SGL <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />