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[ [ [ [ f f f f f [ [ [ [ [ [ f [ f <br /> �1 CHAIN OF CUSTODY f�`CORD <br /> -� <br /> GeologicalaAudit Services , Inc. Date ►- 6 - a `I Page I ► <br /> 1803 West March Lane. Sults A-Stockton.California-95207-(209)958.0284 <br /> Client M(Alifa 5w111vg1,i I 1Vtw70Project Manager <br /> Tests Required <br /> Rob Mur?• <br /> Phone Number <br /> )-oq gy6 - 0;� 6-1 <br /> Samplers: (Signature) Invoice: <br /> Project Name Pure 9 N o 7�f,w,nft�(�,�„I �� ��y GeoAudit <br /> h? , Client p <br /> Sample Location Sample Type <br /> Num Date Time Water Solid No. of ,0;���/.� / <br /> Number Description Air Cont �� �° / Notes <br /> Comp. Grab. / <br /> Mw- 1 /1- 6-qL,) qq 13:30 X 1-/ X x1 1 �V D//6 - <br /> 11W-�'li- 6- q,.) I Li oy Lj Y <br /> M w-3/1- - q W 13, L4 <br /> rtw-5/1 - 6- 9L-1 lugs x x X X <br /> e m is a y: ign lure --- ec ignature Date/Time <br /> R lin shed natu Re i d by: (Sig ure) �- <br /> OatelTim• <br /> Relinquished by: (Signature) Received by Mobile aboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Ostelrime <br /> Method of Shipment: Labors <br /> 1F-� <br /> Special Instructions: I hereb thorize the erformance of the above indicated work. <br />