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r� <br /> Geological Audit Services Inc _ CHAIN OFCUST RECORD <br /> — Date `� 31 R Page � of <br /> E17VII menta/Professionals <br /> .d4 ft Ano <br /> 1803 West March Lane, Suite A Stockton California-95207 (209) 956 0264 II <br /> I <br /> Client E d GOTH �� jt Project Manager a <br /> P( b Tests Required <br /> j Mar <br /> P. U- �q h` 6D 3 Phon Number <br /> I <br /> a7 afi, 02 <br /> � z� <br /> 5 Samplers (Signature) / InvoicAle <br /> Project Name i d- �a I �'��' / /eoAudit ❑ <br /> Cllentl� <br /> Sample Type <br /> Sample Location � <br /> Date Time Notes <br /> Number Description Water Alr Solid Contst %��� <br /> Comp Grab / <br /> i <br /> W-;L <br /> ri <br /> I <br /> elinquished by (Signatur ) ign re Daterrime <br /> fkms, �t 5pTan�crrc T, A.T g'�l•93X17 qC� <br /> Rely qui (Signatu ) <br /> 17ived by (Signature) f ��y l 1P � <br /> Pate/Time I <br /> mac` <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DatelTime Rec iv d for L bvratory b Dale/Time <br /> 41 <br /> Method of Shipment �� Laboratory Name <br /> 5 rja41-- <br /> Special Instructions I hereby authorize the performance of the above indicated work <br /> cr <br /> iy <br /> f <br />