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( Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc Date ' Page -3— of <br /> 837 Shaw Road - Stockton, California 95215 (209) 467.1006 - Fax (209)467-1118 <br /> ClientO� o� Protect M ger/ A 6� S <br /> 1 4 4�A.f Tests Required <br /> Phone NLlmber <br /> Samplers (Signature) invoice <br /> Protect Name �T,J ` <br /> AGE <br /> Client ❑ <br /> Sample Location Sall' ple Type <br /> Number Description date Time Water Air Solid NoOf <br /> l�q� s� Notes <br /> Comp Grab ,tel <br /> I <br /> e rn Oad by lure} ace ve y rgnalure <br /> Daterrime <br /> Relittiquished by (Signature) H d� <br /> Received by (Signature) <br /> oku <br /> Date/Time <br /> Relinquished by {Signature} Received by Mobile Laboratory for field analysts (Srgnature) <br /> DatelTime <br /> Dispatched by {signature} Daterrime Reserve ( Laboratory by <br /> lerrime <br /> Method of Shipment Laboratory am /` y <br /> Special instructions r <br /> I hereby horrze the p formance of the above sated work <br />