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�.. +��.�� ■ter aiiiiiiiiiiiiiii T � Ir I• <br /> Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date - Z1- -G'o Page of -� <br /> of Norlhem Othfointa <br /> 1803 West March Lane Suite A Stockton California 95207-(209)956-0264 Fax(209)956.0700 <br /> Client G(1 �� P:o� na er <br /> ...., Tests Required <br /> Phone Number <br /> 0z)C1 r c, 5 b - C>,-?b V <br /> Samplers (Signature) Invoice <br /> Project Name Ckk 'l �+ AGE <br /> nn Client <br /> Sample Location Sample Type r <br /> Number Description Time _ Water Solid No of C �, Notes <br /> Comp Grab Air Conts <br /> X <br /> /M%L��] J" �.r V, Ic <br /> HpqLl <br /> epurs e y (Signa Received by { ignature i ' Date <br /> lTrme—fishe rjL— <br /> -7RelrnquSignature) Received by (Signature) -4 V <br /> DatatTime <br /> SOD <br /> Relinquished by (Stgnature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time R ry d for abor or by <br /> tg�Tr�ne d <br /> Method of Shipment Laboratory N <br /> e ru' ha e <br /> f� <br /> Special Instructions I hereby authorize the performance of the above tnd,caled work <br /> n <br />