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�! f CHAIN OF CUSTODY RECORD <br /> Geolo' gical Audit Services , Inc . <br /> Entritranmenta Ptafe,�snona/s Date Page of <br /> v=�= <br /> 1tl03 1Nea1 March Lane, Suite A•Stockton,California-95207-(299)956.0264 <br /> MNPV <br /> Client Project Manager <br /> —%b Hqjly Tests Required <br /> Phone Number <br /> Sam lers: (Signature) ] +�� Invoice: <br /> v <br /> Project Name f'.S �/J , ��\ GeoAudit-W <br /> .�Y Client ❑ <br /> Sample Location Sample Type <br /> Number Description <br /> Date Time Water Air Solid Co. of Notes <br /> Comp. Grab, <br /> MW 13.2 •9S .2g-9s ro:Cn X <br /> z <br /> 14w 3-0lq) �-5S X X1 I 1 7 <br /> MW3 3 .qS' to: ti c9 JY 1 — 5 <br /> e r y; ignalur eceive y: Igna a Date[Time <br /> 1-7y-0 <br /> Ralrnquished by: Signs re} Receive b (Signat e) <br /> �-- � '� Date/Time <br /> kqu <br /> Relinquished by: (Signature) Rec ive de Laborato for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: DalefTime <br /> Method of Shipment: Laboratory Name <br /> Spacial Instructions: <br /> I hereby authorize the performance of the above indicated work. <br /> ILI_ <br />