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�... Itf� tfftffl• � � l• � � � � � � � � � � � <br /> ( Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmentai, Inc. Date ° Page ---L or— <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006-Fax (209)467-1118 <br /> Client E(-eC e1. kftlpecitger� -ft, rTests Requtred <br /> r67 <br /> Samplers (Signature) Invoice <br /> Project Name n '} AGE <br /> 4k Client ❑� <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Corns �` Notes <br /> Comp Grab <br /> }I -1 c603d 3�y 0126 <br /> e mquis ed bi-0,Wnauirel 7 Receivedy <br /> 74;� <br /> im <br /> a3 <br /> Relinquished by (Signature) Received by (Signature) 14 <br /> DatelTime <br /> Relinquished by (Signature} Received by Mobile Laboratory for field analysis (Signature) ; Date/Time <br /> Dispatched by (Signature) Date/Time Received for labQratory by - Date(ri e <br /> Method of Shipment I{, o ; <br /> `ti Laboratory Name I <br /> Special lnatruc110ns l I hereby authorize the performance of the above indicated work <br />