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ZVI <br /> Oil <br /> CHAIN of CUSTQD ECORD <br /> =-� Geological Audit Services , Inc. Date � t� Page of �- <br /> � =.V Eimmnmen�a PmJessionals <br /> 11111ILMINIF 1803 West March Lane,Suite A-Stockton,California-95207 (209)958-0284 <br /> MWr <br /> Client d {�ode 6l F Project Manager <br /> 13o b mqe)y Tests Required <br /> p. 0- pox S S LO 3 Phon Number <br /> "4 Co <br /> Samplers (Signature) Invoice <br /> Project Name M i - CO( ,!l . MA S _ % �'� / GeoAudlt ❑ <br /> Client <br /> Sample Location Sample Type <br /> Date Time Solid olid No of .�;�1 / , <br /> Number Description / Notes <br /> Comp Grab Air Conts <br /> IV x <br /> i <br /> VV y <br /> i <br /> e gms e y ignetu MSi r <br /> me p <br /> 5 c{ T,PI-T� DalelTime <br /> la et Jar- <br /> Ref qui (Signatu ) R ceived by (Signature) r l o,,I* i m c f w4p Q A�(,� <br /> ate/Time r <br /> Relinquished by (Signature) Received by Mobile Laboratory for Geld analysis (Signature) Datejime <br /> Dispatched by (Signature) Date/Time Rec ry d for boratory b <br /> DatelTime <br /> Method of Shipment Laboratory Name <br /> 5 ��r <br /> Special Instructions 1 hereby authorize the performance of the above indicated work <br /> � �elc� <br /> r <br />