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Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. Date Page ___L of <br /> 837 Shaw Road Stockton, California-95215 -(209) 467-1006- Fax (209)467-1118 <br /> Client Pr ie Man Tests Required <br /> Phone Number <br /> lC� <br /> amplers (Signature) Invoice <br /> Prosect Name AGE 211� Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts Nates <br /> Comp Grab <br /> 2- <br /> MkJ )two <br /> ,.. <br /> 43 <br /> e inqu a y i to ece. y gnature ate/Time <br /> Relinquish d by (Sign AMveddN a� � - Q telTime <br /> APF p <br /> Relinquished by (Sign jWjN g 1 b obits Laboratory for Ilei ana yafa (signature) Date/Time <br /> IN WJLa . <br /> Dispatched by (3ignature) datefTime fie I or Laboratory at* a00 <br /> 1 lvzw � <br /> 10 <br /> Method of Shipment Labofatork N1610 � <br /> V vctu !� GV— <br /> " 'Q_�i 11-�I <br /> Special II 9ns`,r } ������ �� � /1� � I hereby eu Drize hep rma ca of thea ove indicated work <br />