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Advanced CHAIN OF CUSTODY RECORD <br /> I- GeciEnvironmental, Inc. OR_O ?s�— Dafe S-16-`2"� Page --Lot--f- <br /> 837 <br /> ageLot--f-837 Shaw Road-Stockton,California-95215-(209)467-1006-Fax(209)467-1118 <br /> Client ts�u uit . �F F 5�r n 0.(m Project Manager Tests Required <br /> z l�-r}' Nlt•t•i-� <br /> Prfone Number <br /> Samplers: (Signature) Invoice: <br /> AGE K <br /> Project Name u a. S(e ;n Lc J `v�cr Client ❑ <br /> Sample Location Date Time Sample Type Solid No. of// Notes <br /> Number Description CompJater Grab. Air Conts <br /> S-2c 20' iso x ► lanttd ` <br /> xPr�� i.�cic:�Y��fiIM <br /> e mgws • y:1 i9nature esrve Y: gnalure Dale ime <br /> Dale/Time <br /> elfin ished by: (Signature) Received by (Signature) <br /> Relinquished by: ISignaturo) Received by Mobile Laboratory for field analysis:( w) Date/rime <br /> Dispatched by: (Signature) Dete/Tlme RaceivI <br /> o r : Date/Time <br /> Y. ")5 v <br /> Method of Shipment: CLaboratory Name T6L-tt f�L� �fv.�R-IJ'�i�T <br /> Special instructions: $Z(evb •Cl.;plly [jC0.V� kil ��o�roe�� - - 4' f iSDerb Py) attC!aak) 1 hereby authorize the performance of the above indicated work. <br /> l 011Z VI r t`,%4 hr.-`r <br /> aJ <br />