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mob F ll� mob w <br /> -2,3�2 CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . pie gg3 page of Z <br /> Enk7mnn7amj Professionals <br /> 1803 West March Lane,Suite A-Stockton California-95207 (208)956-0264 <br /> Client E GOTP. l j�� Project Manager Tests Required <br /> QDb har)� <br /> F. 0. Roy 15 S to 3 Phone Number <br /> 5 T o cVe h C ��Q� Samplers (Signature) ,/Invoice <br /> Project Name Mrd- Gq /GeoAudit E]Client <br /> Sample Location Sample Type No of '� /J /� <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Gro <br /> N —3 01' U0{raw S , f7'friw+ W <br /> I <br /> E, DC <br /> B 7— 32- <br /> z2- 3 ) <br /> 2.z2-- 3a <br /> w - Z� <br /> F - ). <br /> Relinquished y rgnature a ry gnat re <br /> SYgncf aQate/Tima <br /> nd I A T a-3i- tern T; d <br /> e y { r ature) Received by (Signature) p l e a S d t r} C I u p Q A/0 Ct pate(r�me <br /> r <br /> Relinquished by (Signature) eceived by Mobile Laboratory for field analysis (Signature) Datelrrme <br /> I <br /> Dispatched by (Signature) Data/Time Recery r Lab o tory by DatelTime <br /> 3 2, <br /> Method of Shipment l/Aboratory Name <br /> Pay' t <br /> Special instruction I hereby autftvtk4 the performance of the above indicated work <br /> �d lL rw� <br /> f <br />