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CHAIN OF CUSTODY RECORD <br /> —_ Geological Audit Services , Inc . Date �� 3 y� Page Z- <br /> Enof <br /> vironments Pro/essiona,& <br /> s.i 1807 West March Lane, Suite A-Stockton,California-95207-(209)956-0264 <br /> Project Manager <br /> Client G �. 7�/� �1. L _, • Tests Re-rlquired <br /> Phone Number �T� <br /> Samplers: Signature) / / /Invoice: <br /> Project Name �7 (t,t k,"2 r-.� Yom. /Y/ / '� / /'Ge Cl ednt <br /> D . <br /> Sample Type <br /> Sample Location Date Time Water Solid No. ofd, Notes <br /> Number Description Comp. Grab. /air Conts. / ,/ / i <br /> L'k1 (^ ti5 LUpb rkj 10 .13 <br /> ) <br /> 'u ,� � ;7/ <br /> 6 tit, #-7 2 /6 .13 v l <br /> Ulu ? —3� ti 1 � 7 !c-w4 / <br /> L --7 -57 �UrLt L tP� ss lu"1th 4ti <br /> i yw e . ( ignature) neceived <br /> �y: ignature / Date/Time <br /> Relinquished by: (Signal Ural Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) Receiv b Mobile Labor o for field analysis: (Signature) Dale/Time <br /> /o o? 9.3oA <br /> Dispatched by: (Signature) DalerTime Received for Laboratory by: <br /> Dale/Time <br /> Method of Shipment: Labora cry Name .} <br /> Special Instructions: I hereby uthorize 4he performance of the above indicated work. <br />