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i <br /> CHAIN OF CUSTODY RECORD <br /> —' <br /> Geological Audit Services , Inc . Date 10-6- Page z of2-, <br /> —_^_— EnY�ronmenta/Pmfess�rona,(s <br /> NELr 1803 West March Lane Suite A Stockton California 95207 (209)956 0284 <br /> Client � �� �` ID�[�� Project manager Tests Required <br /> p c 55i<b3 Phone Number <br /> 5-TD c�/- ( q� zo5 z� � - z6 <br /> Samplers (Signature) Invoice <br /> ` GeoAudit ❑ <br /> Project Name ri )d - Cl I �'c (�7x /`/ / Cftent <br /> Date Time <br /> Sample Location Water Sample Type Solid No of �� , Notes <br /> p <br /> Number Description Comp Grab Air Conts / <br /> S - 7 <br /> e m isr (Signature) eceive y (Signature <br /> Relinquished by (Signature Received by (Signature) DatetTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date(TimeAll <br /> d foLabor ry by Date/Time <br /> c <br /> Method of Shipment LaboratontNam_ e <br /> IT <br /> Special Instructions I hereb author the performance of the above indicated work <br />