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( Advanced CHAIN F USTODY ECORD <br /> GeciEnvironmental, Inc. Date Sri Page --/— �� <br /> 7 IF <br /> 837 Shaw Road - Stockton, California-95215- (209)487-1008- Fax (209)467-M8 <br /> Client Protect Maria er LJ 110 <br /> 4�"A, Tests Required <br /> PNumber <br /> hr t <br /> _ "a, ' 4DSa leis (Signature) Invoice <br /> AGE <br /> Project Name Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab <br /> q3,q <br /> My�()'O • 'Gz- <br /> 1 Iz1 <br /> w Q �_n2X ` <br /> e mq s e ,gnT Received by (Signature) <br /> D to inns <br /> a ez G�L� <br /> Relinquishe by (Signature) Received by (Signature) Date(rime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) DatelTime Received for Laboratory by Date(Tims <br /> Method of Shipment Labor Name <br /> t <br /> Special Instructions I fiereby onze th erformance of the above indicated work <br />