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lZ Advanced CHAIN PF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date �' Page -�� of <br /> 837 Shaw Road- Stockton, California- 95215 - (209)467 1006 - Fax (209)467-1118 113 014 <br /> Client c Profect Manager <br /> y <br /> rTests R aired <br /> P 77 -t�i4l <br /> umber Z <br /> Z-6 Rtl' 7-1 <br /> Samplers (Signature) Invoice <br /> AGE <br /> Project Name i5u' Client ❑ <br /> Sample Type <br /> Sample Location Solid Na of Notes <br /> Number Description Date Time Water Air Cants <br /> Comp Grab <br /> i� DA O�(6 yak md, 21q7 <br /> L'� toW I tvtw I D G I t''p(' <br /> ,W e 1 D C L'�2Z <br /> /V <br /> rK Ly y <br /> e inqu e y (Signature) Received by ignature Dat /Time <br /> fair ©4/ Tao <br /> Relinquished by (signature) Received by (Signature) �}— DatWr <br /> Relinquished by (signature) Received by Mobile Laboratory for field analysis (Signature) I DatelTrme <br /> Dispatched by (Signature) Date/Time Received for Laboratory by ` Date/Time <br /> YCJU 0 <br /> Method of Shipment Labors to arria,,,f <br /> 6 Veil- G <br /> Special instructions ft I hereby authorize the performance of the above In cated work <br />