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CHAIN OF CUSTODY CORD <br /> *Advanced <br /> Date d.3 (page of <br /> - GeciEnvironmental, Inc. 'Z,u �- <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1906-Fax(209)467.1118 <br /> Client C' o ,� . �. � Project Manager <br /> L- i f�l 4L � � � Tests Required <br /> Phone Number <br /> ab f - Hb 7- 166(o <br /> Samplers: (Signature) �AV Invoice: <br /> AGE 19- <br /> Project Name V� R n uS i� y r �� l�E �` C Client ElI l� Sample ype a <br /> / 7J <br /> Sample Location No. of � � <br /> Number Description Date Time Water Solid �� Notes <br /> p Comp. (arab. Air Conts. iL <br /> c <br /> tzs <br /> X <br /> OW7 <br /> _. .6_f 7.14.-- <br /> rw>; %o3,Jx0l 3v2-�� 14)-oX 6.1715 <br /> Relinquished y: (Signature) ece ve y: (Signature) DatafTime <br /> e34201rsy.s' <br /> Rat! wished by: (Signature) Received by: (Signature) Datarrime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysls: (Signature) Date/Time <br /> Dispatched by: (Signature) DatelTimeabor ry by: Date/Time <br /> a ed o1 L <br /> Method of Shipment: Laboratory Name r <br /> CLQ over- oitk"IF 1��C: �tn✓'°1 � j� <br /> Special Instructions: 11f WASOCG NfETAIS OTifE{ri I hereby authorize the performance of the above indicated work. <br /> ICER° <br /> GOOD CONDITION APPROPRIATE ��• <br />