Laserfiche WebLink
r[tttttrrtw tl! 1wi1n� ! ■■■� iimii I♦ imi Ml <br /> t Advanced CHAIN OF CUSTODY'rECORD' <br /> GeciEnvironmental, Inc. Date -i5 ^� Page Z of-3 <br /> of Noalteni Califonria <br /> 1803 West March Lane,Suile A-Stockton,California-95207-(209)956-0264-Fax(209)956-0700 - g (� <br /> Client �� � ��? T, �j-�4 VrrA rl Projec�danager <br /> V[I�A Tests Required <br /> Phone Number <br /> oQ <br /> Samplers: (Signature) �° Invoice: <br /> I <br /> Project Name 1 1 1 AG <br /> Client p 1 <br /> Sample Location Sample Type <br /> Date Time No. of i<; <br /> Number Description Water Air Solid Conts. P� <br /> Cam Grab. <br /> ` r ' r, (fr p <br /> ZJ 50!I P o(' r Zo t'1 � <br /> r: <br /> Pl' 35 3s > 5 .5a I <br /> PL y o - X <br /> yS , a � <br /> e huts a y: Signal rej ec ve y: (Signature) <br /> DatelTime <br /> R <br /> S 7 ll j-2 c� -- I <br /> ,�c�lc v�- <br /> Relinquished by: (Signature) eceived by: (Signature) Date/Time <br /> 1JA0 r4� pvn) <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: Laboratory Name <br /> M('(-Ar4 j A� Ch 1 <br /> Special Instructions: I hereby author'z th performance of the above indicated work, <br /> E G�� <br />