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l Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date 7-Z -1 page --a of- <br /> U <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 1` <br /> Client project Manager `�- ` <br /> Tests Required ;. <br /> Phone Number <br /> Samplers: {Signature �~ �� Invoice: <br /> V r� <br /> AGE <br /> Project Name (� S Client <br /> Sample Location Sample Type No. of �`✓ <br /> P <br /> Date Time Water Solid Notes <br /> Number Description W- Air Conts. � <br /> - Comp. Grab: <br /> 1 Z7 4�' �l N6.92 <br /> v <br /> 7—Z7-- f� -U pC �.._._Na►92784 --- <br /> Relinquished by: ( i elute) [Rever y: (Signature r ��Q�(f'G Dat elTime <br /> - 7-z7^ 5�ca <br /> Relinquished by: (Signature) e ' ed by: (Signatu(b) Dale/I$m <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Dale/Time Received for Laboratory by. Date/Time <br /> Method of Shipment: �l - cl !� 01 ghc (I <br /> Laboratory Namea <br /> iLM <br /> - <br /> Special Instructions: VOAS ON MUAIC OTHER I hereby authorize the perform; of thea ova Indicated work. <br /> GOOD CONDITIONIiOPRIATE <br /> HEAD SPACE ENTAINERS <br />