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i x <br /> Advanced CHAIN OF CUSTODY REOORD <br /> GeciEnvironmental, Inc. � � Date �J Q� Page Of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1008-Fax(209)487-1118 <br /> Client Ci Project Manager <br /> 0 & T� Cy e- AsTests Required 4 Z)F <br /> Phone Number <br /> )ol '-w- 160(a <br /> Samplers (Signature) .9 Invoice, <br /> Project Name � AGi=A <br /> rckC, V- C.. � C��e. � �'� Client <br /> Sample Location 5ampl ype (3 <br /> Number Description <br /> Date Time comWatearr&b Air Solid Con sNo f , I Notes <br /> ; 49178 1-"' s <br /> y _ <br /> MVJ3/C W MW -3 Jim �Z-zr X 49178 --, <br /> 1� <br /> eInquss e y Ignatura Received y gnatu Date/Time <br /> -Fir ab <br /> Relinquished by (Signature) Received by (Signature) DateRlme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature} Dateffime <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> i <br /> Method of Shl ent4� n rr <br /> i S ! -,- <br /> Laboratory Name <br /> MCICA <br /> Special Instructions . r "tI - _� �_�� _ . <br /> I hereby author ze the performance of the above indicated work <br /> 4 <br /> )01e4- «c S'C� / <br />