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. 0 <br /> CHAIN OF CUSTSY RECORD <br /> Geological Audit Services , Inc. Date 7 -79-5`1 Pagn <br /> ' £nvimmm�nr.� Pm1n.�sh�nrids <br /> 1803 West March Lane, Suite A- Stockton,California-95207-(209)958-0284 <br /> P <br /> r <br /> Client q Project Manager <br /> (� Y. L �c1�eto� Pic dole Marl, Tests Required <br /> Phone Number <br /> (coq ) q5b- °.�dt-1 // <br /> Samplers: (Signature) Invoice: <br /> v� /GeoAudit [C7 <br /> Project Name G Q wA KP rr /. / Client ❑ <br /> Sample Type <br /> p Date Time Water Solid <br /> Sample Location <br /> J/ i <br /> No. of 9 :� /� Notes <br /> �' <br /> Number Description Comp. Goab. Air Cants. <br /> v w - 7 A /:z .�s-a <br /> Relinquished y: ( ignalure eceive y: (signature) Date/Time <br /> Relinquished by: (Signature) Received byi(Sidnaturel Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Dete/'time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Dale/Time <br /> Method of Shipment: Laboratory Name <br /> Ne ToXicS <br /> Special Instructions: I hereby authorize the performance of the above Indicnind Work. <br />