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CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc. <br /> —' Ern�imnmenta Prnless�for7air Date )2' -4 3 Page 2-, of Z <br /> . <br /> _ <br /> �� 1803 West March Lene,Suite A-Stockton,California-95207-(209)956-0264 <br /> 0 <br /> r. <br /> ClientProject Manager <br /> Cq [ ron 'S Mgrke Rdb Mra✓ t% Tests Required <br /> Phone Number <br /> coq q66-0249 <br /> Samplers: (Signature) / Invoice: <br /> ,/ � X244 � / / / /GeoAudit <br /> Project Name CQ [c�>ro N's MdrKt Client ❑ <br /> Sample Location Sample Type No. ofr}/Z. <br /> Number Description Date Time Water Solid ��; Q Notes <br /> p Comp. Grab. Air Conts./�/'/A � <br /> N , Noyl t+ wa 113-'00 X I I X <br /> Relinquished by: ( ignature) Received by: (Signat Date/Time <br /> OLx a � STao dard T.A-T, 12_17-73 <br /> Relinquished by: (Signature) 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 Received for Laboratory by: Date/Time <br /> Method ---F- <br /> of Shipment: Laboratory Name <br /> IpAq <br /> Special Instructions: 1 hereby authorize the performance of the above indicated work. <br />