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.n — <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date Page of <br /> 837 Shaw Road- Stockton, Calitorttia- 95215-(209)467-1006- Fax(209)467-1118 <br /> Client Project Manager <br /> < - Tests Required <br /> Phone Number y <br /> Samplers (Signature)~ ,i Irnroice• <br /> 4 <br /> `Protect Name AGE E]� � >.�� ; ° <br /> I <br /> Client ❑ <br /> 3 <br /> Sample Location Sample Type a <br /> Date Time Water Air Solid Cont Notes <br /> Number Description No f i <br /> Comp Grab <br /> xF <br /> _ y <br /> i, r•,, e �. 7 r F n � '� <br /> —R!finquished by pgnatureee ve y gna ure <br /> Date/Time <br /> F � r <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date[Time <br /> ti <br /> Dispatched by (Signature) Date/Tima Received for oratory by <br /> DatelTlme <br /> Method of Shipment Laboratory Name <br /> ' <br /> Special Instfuedons I hereby authorize the performance of the above Indicated work <br /> f <br /> i t <br />