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t i t E t 1 l t t t t t i t E I I. E I <br /> CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . Date a -g Page � o� I <br /> En�ironmentPfly essiona/s -+-- <br /> �� 1803 West March Lane, Suite A-Stockton, California-95207 -(209)956.0264 <br /> Client � d� Project Manager Tests Required <br /> A015 MRA-71c, <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> Project Name 11).0" zu"it - j39r W e� mZ // GeoAudit VL <br /> ❑ <br /> Sample Location Sample Type <br /> Date Time Water Solid No. of Notes.� <br /> Number Description <br /> Comp. Grab. Air Conts. <br /> o I X wo-oto'?ff 7 <br /> 81-15 �► � <br /> ep C:) <br /> t' ,elp ' <br /> 2-5 + 9111/rY-009>10 <br /> �I-30 <br /> TT <br /> Fie is ignature ecorvo y: (Signa D <br /> Rto/Time <br /> q <br /> elinuishod b (Sign" �' (r 21,Da1e/Tlme <br /> y } ure) oco' by: (Signature) ' >a .� <br /> __ `_� s "-- - / •• , �'li fir Y�� / <br /> Relin uishe Eby: (Signature) Receivod y Mobile Laboratory for field analy (Signature) Date'Time <br /> Dispatched by: (Signature) Dato/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> Special Instructions: 1 hereby authorize the perform ca of the above Indicated work. <br />