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=� Geological Audit Services, Inc. CHAIN OF CUSTODY RECORD <br /> _ <br /> now <br /> Date 3D 2 Page�_ol� <br /> v_ <br /> Client `y"� l�/w'`7� PROD CT MANAGER <br /> N <br /> PHONENUMBER <br /> PROJECT NAME SAMPLERS: iolur ) <br /> SAMPLE LOCATION DATE TIME SAMPLE TYPE <br /> (NATER <br /> NUMBER DESCRIPTION AIR SOLID NO.OF TESTS <br /> Comp. Grab. CNTNRS REQUIRED <br /> i <br /> R linquished by:( i nature) \ fife"d by:(Sig lure) <br /> \ �' /rte �}��•� F47Date/Time ( •..� <br /> Relinquished by:(Signature) Received by:(Signature f� <br /> Date/Time <br /> Relinquished by:(Signature) Received by Mobile Laboratory for Feld analysis: <br /> (Signature) Date/Time <br /> Dispatched by:(Signature) Date/Time Received for Laboratory by: <br /> Date/Time <br /> Method of Shipment: I <br /> I hereby authOnze the performanCe Of the above indiCated Work. <br /> Special Instructions: <br /> SOURCE:Adapted from U.S.EPA,1985 <br /> CCA-100 <br />