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Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date gage of <br /> 4005 North Wilson Way-Stockton,California-95205-(209)467-1006-Fax(209)467-1118 <br /> Client Project Manager Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name AGE/ Client ❑ <br /> Sample Location Sample Type No. of <br /> Number Lcri Ion Date Time Water Solid Notes <br /> Comp. Grab, Air Conts. [ k <br /> I Tqlb <br /> II <br /> fi9993 <br /> i <br /> i <br /> Rel in u slied by: (Signature) ece ve y: 4gnature �^ / f �Date/Time <br /> Relinquished by: (Signature) Received by: (Signature) Date(Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) DatetTime <br /> Dispatched by: (Signature) Date/Time Rec i dor Laboratory b D e/Time <br /> Method of Shipment:A <br /> � Labo Name ` <br /> - 1/ <br /> Special Instructions: i hereby aulhorl2a the rlormance of the above Indicated work. <br />