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_4 <br /> E'7N-- CHAIN OF CUSTODY RECORD e. <br /> _-�= Geological Audit Services , Inc. owe 12 - ► • g3 Page l � <br /> � <br /> =�KEn►�ironmenta Professrona,[s <br /> 1803 West March Lane. Suite A-Stockton.California-95207-(209)956-0264 <br /> ClientProject Manager <br /> L4 ro� 'S Mar(fie 13ob NO Tests Required <br /> Phdne Number / <br /> 2.oq <br /> Samplers: (Signature) / Invoice: <br /> Project Name 6,14 I,6N 5 ►"(arKt t , ?� / �/ //GeoAudit C�R <br /> Client ❑ rr <br /> Sample Type No. of �`Z` N <br /> Sample Location <br /> Number Description Date Time Water Solid <br /> /Ar" <br /> Notes <br /> Comp. Grab. Air Conts. <br /> p , I t7raiNQ9t D:tt � I � ) yj <br /> 1:00 X f X X IT3- �aC�o� <br /> Relinquished by: (Signature) Rec <br /> vve y: (Signature) Date/Time <br /> 510 4qr T <br /> Relinquished b � �� <br /> Relin <br /> q y: (Signature) Received by: (Signature) <br /> 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 rime <br /> Method of Shipment: Laboratory Name <br /> A I p k <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />