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CUSTODY RECORD <br /> � Advanced CHAIN OF CU � <br /> -- - " GeciEnvi ronmentai, Inc. 5',Z zq e Date Page --,t of <br /> 837 Shaw Road- Stockton,California- 95215- (209)467-1006-Fax (209)467-1118 <br /> C#tentProject Manager Tests Required <br /> SSS U� <br /> Phone Number <br /> a5 <16214b� p� <br /> Sample (Signature) �L Invoice <br /> AGE,K <br /> Protect Name VA . 1 AW Client ❑ <br /> N C? Sample Type Na of <br /> Sample Location Date Time Water Solid Notes <br /> Number Description comp Grab Air Conts ` a <br /> 1. <br /> 68096 ; <br /> f'cs o `�/ui�! lass <br /> 3 II 68097 <br /> 68098 <br /> 177 w z 2- <br /> 6<z/,0 <br /> ° ° �j 68099 <br /> mw Z 3 oS .3 <br /> t I 68100 <br /> r <br /> F1 <br /> Received y ignature <br /> ostalT� <br /> __ I <br /> e mq y ( nature ZI 0/ <br /> Reli fished ign e) Received by (Signature) D ITime <br /> Date/Time <br /> Rehnqu�shed by {Signature} Received by Mobile Laboratory for field analysis (Signature) <br /> Dispatched by (Signature) Date/Time Received for Laborate by D te[Time <br /> La ratory Name <br /> Method of Shipme <br /> d tlli /41 �4 <br /> Spacial instructions I�`�}a � s���¶�� I hereby auth ize the performance of the above indicated work <br /> Fir^17A -�.3IT V 0Ni''ERS <br />