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� � s• ttti tt� � I•� >• ■■■■ f� fi_ s, Ifiiiiiiii/ Iii »—r tom■■ �� „ <br /> CHAIN OF CUSTOAECORD <br /> Advanced <br /> =i- GeciEnvironmental Inc. °tee Page <br /> ~ 837 Shaw Road- Stockton, California-95215- (209)467-1006- Fax (209)467-1118 V_� <br /> Client C Project Manager Tests Required <br /> P)3one Number <br /> Samplers (Signature) Invoice <br /> AGE P?p <br /> Project Name „ 0),AJ�A Client ❑ <br /> Sample Type /V <br /> Sample Location Date Time Water Solid No of Notes <br /> Number Description Comp Grab Air Conts <br /> �a <br /> quis a igna ecerve y ignature DatelTlme <br /> uished by (Signature) Received by (Signature) Date rime <br /> Y <br /> Relinquished by (Signature) <br /> Received b Mobile Laboratory for field analysis (Signature) Dele1'Time <br /> Dispatched by (Signature) Datelrime Received for Laboratory by DatelTime <br /> 4 r <br /> t <br /> Laborat Nam <br /> Method 01 Shipment <br /> I hereb authonz the perfor ce of the above indicated work <br /> Special Instructions <br />