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psi tftftfififil �■� ifiAftfiftfrw tittlill� �r IF tiitititif t: itti� tttititititt■ <br /> CHAIN OF CUSTODYWCOM <br /> �--= Geological Audit Services , Inc . Date 2^ 1,4^�(y Paged— of_n <br /> V_.�. <br /> En►�ronrr�enta Pro/essionals <br /> �� 1003 West March Lana, Suite A-Stockton,California-95247 (209) 956 4264 <br /> r <br /> ClientProject Manager Tests Required <br /> F4 Mur•l <br /> Phone Number <br /> -zK 96, 6- 0,�6q <br /> Samplers (Signature) invoice <br /> Project Name >?w e k� �� 'L J/w(,•(�,,.t, <br /> 0" 2�� GeoAudd 50 <br /> � Client <br /> Sample Type <br /> Sample Location No of ^( 1 / <br /> Date Time <br /> Number Description Water Solid O Q Notes <br /> p Comp Grab Air Ct7nis �' <br /> 14Vl <br /> vw-7A/� ISI -q�l 6 • ov x �t <br />�a Mev- I Ab tq-qq Iy-ra v x 0� <br /> MW- HA /2- 14 --CILI 16 ';Z0 <br /> e inguis ed by ignature) ReceivedY <br /> ig Lure - 4114 Date/Time <br /> tip <br /> Relinquished by (Signature) Rec wed by (Signature) DatslTima <br /> Relinquished by (Signature) Received by Mobile Laboratory lot held analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Recnived tvr Laboratory by Date[Tlme <br /> i <br /> Method of Shipment Laboratory Name � <br /> A I r Toki�L <br /> Special Instructions I hereby authorize the performance of the above Indicated work <br />