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4 0 Apql -0 <br /> C7-0iCHAIN OF CUSTODTRECORD <br /> Geological Audit Services , Inc. Datta Page l <br /> ' Environments Plvmssiona/s <br /> .,. ... <br /> 1803 West March Lane, Suite A-Stockton, California-95207-(209)956-0264 <br /> I♦ <br /> ClientProject Manager <br /> Gewe�a �..�hd pev.ejo t,y+KT �oI7 �4r�� Tests Required <br /> Phone Number <br /> coq q;6-O;tC4 <br /> Samplers: (Signature) v0 Invoice: <br /> Project Name Gp w t l4.j ''�""" 7 •s` GeoAudit 9 <br /> o} Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No. �tia Notes <br /> Comp. Grab. Air Conts.s. q// <br /> nw- I�IIy-r _q N -lo�tt,� �- <br /> ��7� 7 <br /> e`mgws a,yb�y: (signature) eceive y: (Signature) � DatelTime <br /> Relinquished by: (Sig ature) o R �/! d by: ignat neJ y Date(Time <br /> Relinquished by: (Signature) Received by Mobile Lal o story for field analysis:(Signal re) O te/Time <br /> NIC <br /> Dispatched by: (Signature) DatelTime Received for Laboratory by: Da errime <br /> Method of Shipment: Laboratory Name <br /> Gea Awa( Itcq <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />