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i• i, 111111111111111110 111111M <br /> CHAIN OF CUSTO RECORD <br /> T Geological Audit Services , Inc . . Page <br /> EV— Date ^ o>nlo / z <br /> 1803 Weal March Lane Suite A Stockton,California 95207 (209)956 0264 <br /> A <br /> Client (� Project Manager <br /> ������ �N ����❑ ��`� Bob Ma rly Tests Required <br /> Phone Number <br /> CLO q) 95 6-OA614 <br /> nature <br /> Samplers (Signature) <br /> g ? C4 Invoice <br /> Project Name U4wt� p �"Wr �.t9 0j' "� / / l%GeoAudit <br /> Client <br /> Sample Location Sample Type— No of / } •�� <br /> Date Time Water Solid - ' <br /> Number Description Camp c��b Air Conts � �/ Notes <br /> r'omw- 1 fl /2- $-11.1 'A-;9q-q { 9= �1- X <br /> Mw -H A /x �5�� to <br /> Ia: ; U X__ _ <br /> 1 x <br /> v w-6 A qLi J�FFF <br /> e mquis e y ignature eceive y (Signature) <br /> Dele/Time <br /> ;-;P-qq Is:co <br /> Relinquished by (Signature) Received by (Signature) �J, ,f,' ���,,// ., p <br /> Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory lot field analysis (Signature) �j <br /> Dale/Time <br /> Dispatched by (Signature) DatelTrme fie d tV777�4 <br /> Datefrima <br /> Method of Shipment Lab ralory Name <br /> Special Instructions <br /> laic <br /> I hereby authorize the performance of the above indicated work <br />