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Advanced CHAIN OF CUSTODY RECORD <br /> GeciEnvironmental, Inc. �a/� aJ� Date L Page [. of <br /> 837 Shaw Road-Stockton, California-95215-(209)467-1006 - Fax (209)467-1118 <br /> ClientC 7 n Project Manager© �(}� W{I� X711�i +.,,{,/ r:)•`V 0 �' Tests Required <br /> 7 — r-�C1iro11'Z.1�-fd1i�1 U-r <br /> Phone Number % <br /> Samplers: (Sin ure) ) —� // � �� Invoice: <br /> Project Name AGE <br /> ClientSample Location Sample Type , <br /> Number Description Date Time Water _J �� Soli,; Cis 1(t ��n / / Notes <br /> Comp. Grab. <br /> /7JJ? 4 x I �x <br /> AN <br /> x <br /> crha ass: x <br /> t:Ci13,0. yJ:-t Dy Y INI <br /> e mqumhvd lit,( nature) scene y: ignature D tolTim <br /> Lo f 0c)alinquished by: (Signature) Received by: (Signature) <br /> DateirTiOne <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis:iSignatuns) < � Datefrilhe <br /> Dispatched by: (Signature) Date/Time Race'�for�' ons'" :i of ims <br /> Method of Shipment;/1 � Lab ry Name <br /> Special Instructions: i hereby authorize the Oatlormance of the above Indicated work. <br />