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-. . <br /> CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc. Date IL-77-R3 pageD( Z <br /> En✓iicv7menta Professronafs <br /> v_- <br /> �� 1603 West March Lane, Suite A- Stockton,California-95207-(209)956-0264 <br /> Client Project Manager <br /> 7� l�l.w-�`7 Tests Required <br /> Phbne Number <br /> Samplers: (Signature) Invoice: <br /> (y,1,n �t ��ti /GeoAudit DO <br /> Project Name �owrkr 0� <br /> Client ❑ <br /> a% /%b, <br /> Sample Location Sample Type No. of b�/-1 Q- <br /> Number Description Date Time Water Solid Qj Notes <br /> p Comp. Grab. Alf CDnts. <br /> r'W,I/I;--;- q3 17--; r-vO 17: z0 X 7 X rx W <br /> 6yj> ^�nJ <br /> y s v 3 3 <br /> nw-6/1;-? q3 1&1,00 <br /> Mw-7/Ira -q3 16: 17 x 7 1( <br /> i <br /> Mw -I1 /►r 7•q ts:3a X 7 X be X k ; i <br /> `r p, <br /> O d <br /> Mw-I3/,y 7-93 IS , 5y X ]' y 7( x <br /> e iq he b ignature) ace ve i nature <br /> Ck. t-r_ ^ dvC_ Sfy.or1'R( %u2,Y A�4ir.uCa r !()•'Ss�4 <br /> R In"h d by: (Signature) Receive : ($ignature) Date/Time <br /> C2 - ta.1- 9 34o w. <br /> Relinqurshe by: (Signature) R by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date[rime <br /> Method of Shipment: L V71 n p n trr�sr a []]HER <br /> Labor /oorry N/arse / <br /> YO131 niC 'L 6' ul C ; 21�' A <br /> Special Inatruchons: GOOD DONDIT1014 APPROPRIATE I hereby authorize the performance of the above Indicated work. <br />