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CHAIN of CUSTODYIECORD <br /> Geological Audit Services , Inc. <br /> Date�-t�-�� Page �. Z <br /> ��� EnYironmenta Prolessiona,Cs <br /> �� 1800 West March Lane, Suite A-Stockton, California•95207-(209)956-0264 <br /> t� <br /> r+r <br /> Client (� Project Manager <br /> eui tK,? �4K�1 Q�✓?�o �+?�'vt Bc�� Mt�r•�Y Tests Required <br /> Phone Number <br /> 3,oq WSis ~ o�b� <br /> Samplers: (Signature) Invoice: <br /> Project Name bewel,%p ' `,'�/ / ,eoAudit Q <br /> .a Client 0 <br /> Sample Location Sample Type No. of <br /> Number Description Date Time Water Solid Notes <br /> Com Grab. Air ContS. O/ / ! i <br /> P. �. <br />� law -( �q/� -t�l�q '� ��+a-qty � 6-� � � j x •� +' <br /> e inqurs a y: (Signature) ed y: atur 7,Y1 Dale/Time <br /> 7 <br /> Relinquished by: (Signature) 'ABC e v d by: (Signalure) i Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis; (Signature) Datel'time <br /> jL <br /> Dispatched by: (Signature) Dale/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br />