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CUSTODY RECORD <br /> Ci�l OF C . ' <br /> Geological Audit Services , Inc. Date CHAIN N OFPage / of <br /> _ �7A Environi7"R Pr016$Snna,[s <br /> 1803 West March Lane, Suite A- Stockton,California-95207-(209)956-0264 <br /> low <br /> }Lt_ f' M Proje Manager <br /> Client ' f Tests Required <br /> Phone Number <br /> y"1 '/tiZ —C z& � � <br /> i <br /> Samplers: (Signature) ] i %//,/Invoice: <br /> /Invoice: <br /> Project Name r , ,� //GeoAudit ) <br /> 666 Client ❑ <br /> Sample I Location Sample Type No. of k / <br /> Number Description Date Time Water Solid %�� Notes <br /> p Comp. Grab. Air COnts.� <br /> Y i <br /> i <br /> Vw'- 5 W i uE i 1k D � U Izti3 3 �' 1 <br /> Zo' IVU i LCO 5 Za ' 0 )l ti; 3 ­5-� r <br /> 0.5 - -3 uo <br /> V - i�5 y Ick h3 3 . 75 ) <br /> - LS' <br /> e inUts tl b ignature Received y: (Signature)/ ryDate/Time <br /> Relinquished by: (Signatureo Received by:(Signature) Datefrime <br /> Relinquished by: (Signature) Received b Mobile Labora or field analysis: (Signature) Datemme <br /> Dispatched by: (Signature) DatefTime eceived for Laboratory by: Daternme <br /> Method of Shipment: La rstoryName <br /> z�,G_ Cly c /l L <br /> Special Instructions: I hereb uth/o/r/iz/y�he performance of the above indicated work. <br />