Laserfiche WebLink
YV <br /> CHAIN OF CUSTODY RECORD <br /> ' = Geological Audi# Services, Inc. 7-/6 ,g r Page a of <br /> Date �f <br /> PROJECT MANAGER h <br /> ct�an, GEf��Vic- f <br /> PHONE NUMBER <br /> f <br /> PROJECT NAME SAMP RS �i17 urel <br /> i <br /> Mra <br /> SAMPLE TV0E ' TESTS <br /> DATE TIME WATER AIR SOLID NO OF <br /> SAMPLE LOCATION CNTNRS REQUIRED <br /> NUMBER DESCRIPTION Comp Grab <br /> roth8o2q as 1"344 &l d <br /> i <br /> l gVjv+ 70 Mriots <br /> A(GSp_z 5,011 tart c ;e2 -16-41 IDIda Z <br /> { i <br /> I ' <br /> Re nqui5 ed Dy S nature) Received by (Signature) �pyy�0 l re OatelTimo <br /> « d(j > 2d <br /> �--- <br /> A,k.tf 2,< 2� aa.jySiS Id jot I !1 <br /> Rd b (Signature} -- it <br /> DatetTime d <br /> RetingsstsnReceived y <br /> ed by (Signature) <br /> 6,*y 'T(�I?�Ill,eut�rVl� f <br /> Received by Mobile LaborafOf} fow field anaivsis DafelTime <br /> Relinquished by (Signatur�p IS,gnature! <br /> I�Received for by f}aEefTime ' <br /> Dispatched by(Signature) DatelTime i <br /> `iereby autnooze the performance of the above indicated work <br /> Method of Shipment <br /> Special Instructions <br /> 1 <br /> cca=oo <br /> SOURCE AGapr US EPA t985 p� � d <br />