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Geological Audit Services , Inc . <br /> CHAIN OF CUSTODY RECON <br /> �" EnYironmentalPrafessiona/s <br /> VV <br /> 1803 West March Lane, Suite q-Stockton, California-95267- Page o} <br /> (209)955-0264 <br /> Client ead ea S � <br /> Project Manager <br /> Bo P M a 0-1 V Tests Required <br /> Phone Number <br /> t�05 ) 531 - 0-.61-1 <br /> Project Name y k I low <br /> Samplers: (Signature) '� <br /> S Invoice <br /> u ar, F )kk4.f� qf�X 4^'1 GeoAudit <br /> Sampleah Client I <br /> Location Sample Type <br /> Number Description date Time , Solid No. of / <br /> Comp. Grab. Air Conts ��/ / j �' Notes <br /> D -- � ,� p . T <br /> iv� ru� s <br /> D — �, X C0IMP05; e <br /> D - 10 ---_- ___-- --- 3 4 5 5 <br /> 6 t : t <br /> 3 - -)0 <br /> e inqurshed by: (Signature) <br /> 7 ecerved by: ( rgnature) r <br /> Relinquished b(Signature) 5�d ya Q T•14.T� Date/Time <br /> Recei (Signature) "•3 r'Q� l,�j': <br /> Relinquished by; (Signature) (L� Date(T7 a <br /> Received by Mobile Laboratory for field analysis: (Signature) /�y <br /> Dispatched by; (Signature) Da e/Time <br /> DatelTime Received for Laboratory Y� <br /> Method 01 Shipment: Date/Time <br /> Laboratory Name <br /> Special instructions: �[}�? ��� !� ';�;;i' 'i !T -`C C`'��'�►( r r <br /> aiLtEfiii, ""irt i7[ L <br /> I hereby authorize the performance of the above indicated worst, <br /> N:AQRAOIVTA[Iti <br />