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Advanced CHAIN OF CUSTODY RECORD <br /> =' GectEnvironmental, Inc. Dace X06 Page of--3- <br /> 837 <br /> f-- —837 ShawRoady <br /> �oetl- Stockton, California-95215-(209)467-7006- Fax(209)467-1718 O © <br /> Client Project Mane� Mcg Tests Required <br /> zCbPhone Number <br /> C. L4) Rij,, (-1 4 4 <br /> Samplers: (Signature) Invoice: <br /> Project Name q O S2 L„ , AGE <br /> A ' -� Client ❑ <br /> 'V14Ui:,t�' St�tXf2 �\ <br /> Sample Location Sample Type Solid No. ofd <br /> Number Description Date Time Water Air Corns. R <br /> P. Not <br /> Grob. !�_ <br /> -U lAct kkkr ��o t3 tl W-5--e5 (DIlip X 5 <br /> 8-t2--10 " " IDr ltto <br /> 6-12-15 <br /> 8-12 t•�'a U1,,�cF l'ra+"'t B-12 tt4S X S /� <br /> 6-r3 ca 5i t�52 r Abid <br /> a mgws a Y: rgna ure ^ were Y: rgna(ur• DalelT <br /> Nelinquis Y: IS. <br /> alure) e•eeived by: (Signature) Q Dats Ima <br /> • quish•d by: (Signature) Received by Mobile laboratory for field analys4:(Signature) <br /> S`T ` ',T-- Date/Time <br /> m <br /> Dispatched by:(Signature) ete/rima Received for Laboratory by: Date/Time, <br /> Method of Shipment: Laborato ame <br /> Special Instruc/loes: t hereby authorize the performance of the above Indicated work. <br />