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1• <br /> • <br /> Advanced CHAIN OF CUSTODARECORD <br /> GeciEnvironmental, Inc. Date ! s <br /> d� Page 3 of 3 <br /> 837 Shaw Road-Stockton, California- 95215 -(209) 467-1006 - Fax (209)467-1116 <br /> Client % - Project Manager = "I Tests Required <br /> �/� C:r•R-iia✓ <br /> -At 73 77dD Phone Number <br /> eco!'Ovig 7 ` <br /> Sam p rs (Signature) Invoice- <br /> Project Name AGE <br /> Client ❑ <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Solid Conts Notes <br /> Comp Grab <br /> Vw <br /> i ss J ,r --1 Law <br /> e F e y (Signature) Received y lgnature Date/Ti e <br /> Relinquished b ig ure) Received by (Signature) � �� � Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Rec. or Laboratory by Daterrime <br /> Method of Shipment Laborato ame <br /> e i Abe- IU,4 7,icAL <br /> Special instructions I hereby a ortze the performance of the above Indicated work <br />