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%2 CHAIN OF CUSTODY RECORD <br /> Geological Audit Services ( Inc . Date g - 3) -� 3 Page 2 <br /> _=M EYMA017menta Professionals <br /> W 1603 West March Lane, Suite A-Stockton, California-95207 -(209)956.0264 <br /> Project Manager Tests Required <br /> Client E GOT�Q 16, Qob 11grI • <br /> 02 6 <br /> P. O. ao X 5 c1 110 3 Phone Number <br /> / ,,`/invoice: <br /> 5 1p c K 0'1 G� p 9 ) <br /> samplers: (Signature) <br /> , <br /> GeoAudit ❑ <br /> ��,,�;�,, '?tif,���.•G-ter _ <br /> Project Name r-d - GQ Client [� <br /> Sample Type <br /> p No. of ��`, � Notes <br /> Sample Location Date Time Water Salid Conts. <br /> Number Description <br /> Air <br /> Comp. G�. -�. <br /> N -3 O 10 I. <br /> F - ;� 6 E, _ DC <br /> 83- 3-�- <br /> 3 ) <br /> Date/Time <br /> ,y gnat re iIgnc� Qiof I. A.T. <br /> e mqure ed y: ( ignature) e �'3) -73/1 r: <br /> ( J <br /> P 5 4 I-1 C I a Q A/Q C Daterrime <br /> e y: ( i ature) Received by: (Signature) ^� <br /> i <br /> DaterTime <br /> Relinquished by: (signatu(e) eceived by Mobile Laboratory for field analysis:[Signature) <br /> Daterrime Recaiv d r Labo tory by: I ` Date/Time <br /> Dispatched by: (Signature) <br /> 5 � 3 <br /> boratory Name <br /> Method of Shipment: Pit rt t <br /> I hereby au 1-zthe performance of the above indicated work. <br /> Special Instruction <br />