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f Advanced CHAIN OF CUSTOD ECORD <br /> GeciEnvircinmental, Inc. <br /> Date ( D 3 i U Page Z- of �- <br /> 837 Shaw Road - Stockton,California-95215 -(209)467-1006 - Fax (209)467-1118 <br /> Client — Project Manager <br /> , Tests Required <br /> Phone Number <br /> -10 0 <br /> Samplers: (Signature) Invoice: <br /> Project Name � j <br /> AGE <br /> ��� � Client ❑ <br /> Solid <br /> Sample Location ample Type No. oofComp. Grob. �� ' <br /> Number Description Date Time Water Air Conte <br /> Mw- -7� d lis S 3 5 <br /> kx <br /> Y. <br /> fkI� <br /> 1't - u . 11 <br /> kk I <br /> 1\1Y-1v 82472 <br /> Helinqui by.. (Sig a urs Received y: laignatutel <br /> ellnquishe by: (Signature) Received by: (Signature) DatafTime <br /> Relinquished y: (Signature) Received by Mobile Laboratory for lield analysis: (Signature) DatelTlme <br /> Dispatched by: (Signature) DatetTimeecs a or Laboratory y: DatelTlme <br /> 4_9 IUIT /dr /Q M+5110t 1SSV <br /> Method of Shipment: Laboratory Name <br /> VOA C&C i'LTA[S Cf41k,1 ' <br /> Special Instructions: M"J'01M lull I I I hereby authorize lh4 performance of the above Indicated work. <br /> P� t'ATI ON APPROPR1Aif ' <br /> HFA0 SPACE APS�NT— QQNTAINERS---- .-. <br /> 4 <br />