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a CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc. Y ` <br /> .���. <br /> EnVironmenta Professiona/s Date $ ) Page l o <br /> 1803 West March Lane, Suite A•Stockton,California-95207-(209)956-0264 <br /> Client �'� L c� Project Manager agar 6-- S <br /> Tests Required <br /> Phone Number <br /> (� oq) 7 9 6 - 0.� 6q <br /> Samplers: (Signature) invoice: <br /> Project Name G d r o o'5 N ctei4 e T— � +? ,�� �� GeoAudit <br /> Client <br /> Sample Location Sample Type <br /> Number Description Date Time — Water Solid No. of <br /> com P• G,ab. Air Conts. Notes <br /> 5 t r5)0Ct5 . sig <br /> 40136 (Mro5;1+ 5P1-� �- <br /> 5 1 1-1 , iV V/ l o= v I I - - - - - <br /> 5�2 ' 4 , W io.' 40137 r s w <br /> 3O x �� `( <br /> 516ckr <br /> n i o. 3 y i 6fP0 0, 5p3-3 <br /> t' t <br /> 5 P ? -, Ll , 40138 <br /> W , i4 10; qo <br /> e�nquis a by: ,gnature <br /> ecerve y: ig uro Dale Ime <br /> Relinquished b q q 14,Co <br /> Relin <br /> q y: ( ignature) Received by: (Signature) <br /> • Oate/Tlme <br /> Relinquished by: (Signature) <br /> Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) <br /> Date/Time Received for Laboratory by: <br /> Date/Tlme <br /> Method of Shipment: <br /> Laboratory Name <br /> Special Instructions: <br /> lc�_r^' ✓ ` : I hereby authorize the performance of the above Indloated work. <br /> GUU <br /> nha� re. <br />