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( Advanced ` c�X CHAIN OF CUSTODY RECORD <br /> GeclEnvironmental, Inc Date -Lu Page of <br /> CT4 4005 North Wilson Way-Stockton,Cahfomla-95205-(209)467-1006-Fax(209)467-1118 <br /> Client 1 Project Manager <br /> w F,z1 � L, ' Tests Required <br /> Phone Number <br /> t?J) LJUU _ J00L> <br /> Samplers (Signature) Invoice <br /> Project Name AGE ,K <br /> 7 je-,aler- ,� �� Client ❑ <br /> Sample Location Sampl ype �,. <br /> Date Time Solid N0 of <br /> Number Description Water NotesAir <br /> Comp Grab Conts <br /> �t.,x,�/►1+a r�� �I�/—cam tt-►��� 1t�© .� � � / —/ I <br /> e in s y (Signature) ec v Oate/T"me <br /> ; e3g*,�SI - ��Y 11-r y cr✓/ 1,130 <br /> Re ""shed by (Signature) fie eived by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatetT"me <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method of Shipment Laboratory Name ' <br /> CA OWN-A h ,p t, <br /> Special Instructions I hereby authorize the performance of the above indicated work <br /> ' f&M les 4 c l'sd k Loh, , <br /> _Lc, 7l� e eVc� �u <br /> � � � � � � � I• � tfi Ifi t� f! ! ! ! ! ttttttaua <br />