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i <br /> • CHAM OF CUSTODY RECORD <br /> -.� Geological Audit Services, Inc. t <br /> Date 7'1b ( page d''t of <br /> ClientF/(LG r L d1� » PROJECT MANAGER / r <br /> PHONE NUMBER <br /> PROJECT NAME SAMPLERS f a acute} ;f <br /> A'10 -6+t L c; -SIA/ <br /> SAMPLE TYPE r <br /> SAMPLE LOBATION DATE TIME NATER ASR I SOLID NO OF TESTS <br /> NUMBER DESCR(PTiOts Comp Grad CNTNRS REQUIRED <br /> 11tGj� cot <br /> X170; Me—ii►45 G- r' <br /> Af W x Atli Sort PILE�'Z. 1-7-14 ID i dD X �. <br /> oil, py 4 a`z- <br /> Re nqui5 ed by Is nature) Received by (Signature) Date/Time d <br /> Gos+LI�3iT� lfi� � !� �l��2� ,I <br /> ze 42-14taRuw��rSis f��4r It ea sy. <br /> Relinquished by (Signature) Received by {Signature) DatefTirne <br /> Aehnqutst,ed by (Srgnaturej Received by Moble Laboratory to,1ieid analysis Date/Time i <br /> fSit}nalure} <br /> f <br /> Dispatched by(Signature) Date/Time Rece-ved for LaWarory by OatefTirne <br /> Method of Shipment l'7ereby authorize the pertormance of the above indicated work <br /> Special Instructions <br /> SOURCE AaW m U S EPA 7995 CCR 1710 I <br /> I <br /> } ffll <br /> a <br />