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Geological Audit Services , Inc . CHAIN OF CUSTODY RECORDDate Page �2,_ of z <br /> .. ... Enwronmewa protosslonals <br /> low 1803 West March Lane Suile A StocPon Cal1lornle 95201 (2119) 9511 6264 <br /> r <br /> T Project Manager Tests Required <br /> dent Notre 1111nt (orn51ruc � tin„�..._ Lo 136t) Ma►^r 4 <br /> Phone dumber <br /> (coq) g564D26 <br /> Samplers (Signature) Invoice <br /> GeoAudlt <br /> roject Name Now! e ! 10t Lois siru01a� � <br /> � � �?�" `�""' �� client <br /> D� <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Con ts ��' Notes <br /> Comp crab <br /> iw- 2q-ql lx-?q'qq 16-10 X X rf/� -QD .7 Yo <br /> lw -Y/);k - ;kq-q f d= 1�- X W x 00 g/k/ <br /> a inquis a y (Signature) eceivo yignature Date/Time <br /> x� 76 y— <br /> �atrnquishad by (Signature) necdrVed by (Signature) daterrime <br /> Irnqu shed by (Signature) Received 6y Mobile Laboratory for field analysis (Signature) Uete/Time <br /> ispalchad by (Signature) OatelTime Received for Labofatory by i7alerrime <br /> ethod of Shipment Laboratory Nem <br /> Pa m Al <br /> - <br /> Fpecial Instructions I hereby authorize the performance of the above Indicated work <br /> mix x <br />