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Advanced � � � � CHAIN OF CUSTOD ECORD <br /> I � � b� .-v _� � <br /> GeciEnvironmental, Inc Date page of <br /> 837 Shaw Road- Stockton, California 95215- (209) 467 1006 Fax (209)467-1118 <br /> Client 1 Prod anger <br /> Tests Required <br /> P one u tier <br /> Samplers (Signature) �� Invoice <br /> r AGE <br /> Protect Name ,�.-,! /' � , l � � � ,� Client ❑ <br /> Sample Location Sample Type <br /> Sam Na of <br /> p Date Time Water Solid Notes <br /> Number Description Comp crab Air Conts <br /> ot5 W 6'11 <br /> Ibisc a (�C� <br /> lb S-03 �3 <br /> 1� x� <br /> jRefinq.7ise y ignatia a ece ve y ignature Oate/Time <br /> Date/Time <br /> ished by (Signature , Received by (Signature) ST <br /> ft <br /> 1Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) ! DatelTime <br /> Dispatched by (Signature) DatelTime Received tot Lo for by 0 e/Time <br /> toll <br /> Method of Shipmanyl � Laboratory Name/1 e' <br /> v\�-- <br /> ll/ (�J <br /> I hereby authorize the performance of the above Indicated work <br /> Special Instructions <br />