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� i' 1♦ � t♦ t♦ � !� i♦ t' t♦ � i♦ i' t♦ � � <br /> • T D RECORD <br /> j Advanced CHAIN OF CUS O <br /> e ..,fY,`• Page p <br /> - -_ GeciEnvironmental, Inc. Date_.:'` - of <br /> .. t <br /> 837 Shaw Road- Stockton,California-95215- (209)467-1006-Fax(209)467-1118 <br /> Client <br /> Project Manager Tests Required <br /> _ ;F - <br /> Phone Number <br /> r f'# <br /> Samplers (Signature) Invoice: <br /> r' .{•s s...... AGI= <br /> IZI <br /> Project Name Client ❑ <br /> r <br /> Sample T k . <br /> Sample Location , Date Time p YPe Solid No. of y; r ', t ` Notes <br /> � <br /> Number Description Water M w <br /> Comp. GrabAir Conts. <br /> Grab. Air <br /> ., 1' ,k :,� �< 3- � "�, ;z � i,t 4' �;.•ti �.''• Via. ,v c3`' • <br /> e+nqp+s a y: +pf slursReceived y: (Signature) Date/Time <br /> Relinquished by: (Signature)' Received by: (Signature) 15aterrima <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Dataftime Roceived for Laboratory by: DateCTime <br /> I' Method of Shipment: Labor cry Namer <br /> - sir •� Y'7i.'¢ - '.': ::�`.�^-. sN t., '}, _ _ <br /> Special instructions: I tie reby authorize the,performance of the above indicated work. <br /> I <br /> 1 ,i • <br /> i <br />