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Advanced CHAIN OF CUSTOD RECORD <br /> _1 <br /> _ - GeciEnvironmental, Inc. Date ll-I `a� Page Z a Z <br /> 837 Shaw Road-Stockton, California-85215-(209)467-1006- t=ax (249)467-1118 �f J <br /> Client ,n LJ-al-,r Project Manager <br /> CirCc�r' (,J aS� Tests Required <br /> jM Coef lar <br /> Phone Number <br /> 90- 10106 <br /> i� Samplers (Signature) Invoice <br /> Project Name AGE <br /> g U 1 ll Wa}e Client ❑ <br /> --Sample Location Sam Type No of <br /> Date Time Water Solid Notes <br /> Number DescriptionDate <br /> Grab Air Corns <br /> V1WIt4 J1I tie,L Z`I�J <br /> IAF/s c IZc�t f <br /> qwa e y ig lure eceave y (Signature) DatefTlme� <br /> Nnquia a by (Signature) Received by (Signature) Datefrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) DatelTime <br /> Dispatched by (Signature) Dateftime Received ba1ato - �+ Date/Time <br /> _ I <br /> Method of Shipment L o story oma <br /> Special Instructions I hereby authorize the performance of the above Indicated work <br />