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CHAIN OF CUSTOPRECORD E_ <br /> 1 r <br /> =� <br /> Geological' Audit Services , Inc . Date 6P-z3-9+- Pageate <br /> _=`� Enr�ironmenta Protessiona/s <br /> V 1MW <br /> BMW 1603 West March Lane, Suite A- Stockton, California-95207-(209)956-0264 <br /> r <br /> Client <br /> Project Manager <br /> �G�S s� �vr3v� CG �� kJAZ <br /> � Tests Required <br /> Phone Number k <br /> Z�l <br /> Sam rs: (Signature) � Invoice: " <br /> C,eoAud'R <br /> Project Name S U Client ❑ <br /> 5 vl S <br /> Sample Location Sample Type No. of �f Notes ' <br /> Date Time Water Solid <br /> Number Description comp. Grab. Air Conts. II Q <br /> MW 3 G-L3- ,/&J- le Z3-9 9•'76 6GoZ`Y~! — <br /> q sh by Received by' ( nature /, 02 Dateffilme <br /> Relinquished by: (Signature) Received by. (Signature) / Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Daletrlme <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: DatoMme <br /> Method of Shipment Laboratory Name <br /> 0'4- 61/�nrvtG ff <br /> Special Instructions: I here hor17 Ih erformanes of the above indicated work. <br />