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CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . date 3-3� �� page �. of-2— <br /> Eniliraninenla/ProIOSS10n,�r/s <br /> 4803 West March Lane Suite A Stockton California 95207 (209)956 0264 <br /> /Q <br /> r �` L Z5 <br /> I <br /> Client N0 j ` GO in STr VC I l'Oiq L o, Protect Manager <br /> Tests Required <br /> Bb h Mq r l` <br /> Phone Number <br /> (,Z05) 7 Ff`D.l� <br /> Samplers (Signature) Invoice <br /> Project Name �/��1L2 j { L p t�5 T itc:�`l'a� ��A-fC('l+��'(,� ah Ge CI unit <br /> Sample Location Sample Type / <br /> Date Time W7ter Solid No of �y Notes <br /> Number Description At r conts <br /> Cornp Grab +` <br /> MW -1-13- 30`0- 3 X <br /> 0 <br /> Rtlrngws red by (Signature) d by rgnaturr Date/Time <br /> Hulinqutshed by (Signature) Received by ( ignature) DatelTime <br /> Rchnquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Dale/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Dala/Time <br /> I <br /> Method of Shipment Laboratory flame <br /> PRK4A <br /> Special Instructionsi hereby aut orize the performance of the above Indicated work <br />