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CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . Date11 q`! page of <br /> "'— Environmental Protessiona/s <br /> 1803 West March Lane, Suite A- Stockton. California-95207 (209)956-0264 <br /> v- <br /> Project Manager <br /> ;,tient C�QYk G Syel W6L1 ker Tests Required <br /> Phone Number �! <br /> (203),0-1g5(.0-OZ&Z <br /> Samplers: (Signature) Invoice: <br /> GeoAuditg <br /> Name c6v all �ll� iL Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No. of q ' Notes <br /> Number Description comr,. crab. Air Gants. <br /> ��- 30' 1 r �ECL �'$ �1: IS /X 1 X 9V1c2 -000,Y0 <br /> X 0067 93 c <br /> 0 0&j q <br /> >2'36� ori 2 Air fee, z, ZS x X C)O(08 <br /> t z -J�If 2:45- { X d G �l� <br /> 2 f 2 - eek 3:2< X 0 0 6 87 <br /> s i rs a y' igrratur Receivedy: Signature Date/Time <br /> avtd�rGl TAT rt 7;kt0 Pti+ <br /> Reiinqu ed by: (Signature) Received by: (Signature vee ',r I Date/Time <br /> // ('),/2'91 t�- /-z�'�z a"J <br /> ,0 <br /> Retinquished by: (Signature) Received by Mobile Laboratory for field a1 Sis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: DatelTime <br /> Method of Shipment: a Laboratory Name <br /> n - A <br /> SpecialInstructions: I here y authorize ! e performance of the above indicated work. <br /> - 00062 7L <br />