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CHAIN OF CUSTODY RECORD t <br /> FA—Chg Geological Audit Services Inc. <br /> —��� En�ironmenla Professiona,(s <br /> Services , Date I Z' 7 7-93Page of 2 <br /> 1803 West March Lane, Suite A- Stockton. California-95207-(209)956-0264 <br /> Client Cj G Profit Manager <br /> " /. Tests Required <br /> l<3 Lc <br /> Phbne Number <br /> 26x1 * �'Z/11 <br /> Samplers: (Signature) �-� Invoice: <br /> udit 14 <br /> Project Name �j xy4A w1 Wk)"4"' q~ /Geo liens <br /> rw�t Kt <br /> Client ❑ <br /> Sample Location Sample Type No. of ,Z: .�/ <br /> tion Date Time Water Solid Q Y/�; Notes <br /> Number Description Comp. Grab. Air ContS. <br /> 11w-.IN��-1 43 11-17-9 16=vo X x X u <br /> ILI <br /> at ish nature Received Dale/Time <br /> - C -L /J-as'y3 <br /> Imgyjshe by: (Sinature) Received 6 9 gnature) - Date/Time <br /> Relinquished by: (Signature) Receive by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Lab ry Name <br /> Special Instructions: yo(:� 1 hereby authorf a th performance of the above Indicated work. <br /> Ic s r woo, P(D.3 V1, ��.— / / r <br /> �✓ CONTAIPIER-� ��/ `Gw <br />