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Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date f 'JPage ` <br /> 837 Shaw Road- Stockton, California- 95215 -(209)467 1006- Fax(209)467-1118 <br /> Client , c d, M Pr _t anagager Tests Required <br /> MAMal"i <br /> Phone Number <br /> `I(oI d C6(o <br /> Samplers (Signature) Invoice <br /> AGE <br /> Project Name Client E]e- K� , ' <br /> Sample Location Date Time Sample Typeblamer Solid No of �� N Notes <br /> Number Description comp gran Air Conts f '� <br /> Roll Isfied b + nature ece+ve y igna urs Dale/Time <br /> g q`ld -63 /&,eP <br /> linqulshed by (Signature) Received by ;Signature] DatelTime <br /> i <br /> Re inquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) naterTime113so."d f9r4aboratory y �./ k( 11ime�/y -- <br /> Method of Shipment Laboratory <br /> N e <br /> t t hareb aulhorlre thX performance of the above indicated work <br /> Special Instructions <br />