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Geolo Ical' Audit Services., Inc . CHAIN OF CUSTODY RECORa <br /> -= ElWhonmenta/Protessiona/s 9 Date ZE'-�ypage _� <br /> of <br /> 1905 West March Lane, Suite A- Stockton• California• 95207 -(209)9560264 <br /> r <br /> Client FLK CotrnJ Y �-LiES Pro'ect Mana er -�2j/6 !�, <br /> r- Tests Required <br /> IC�.� R -�Vf✓ G7 E c ?1_a Phone Number <br /> Samplers; (Signature) <br /> Invoice: <br /> Project Name CLV(P 1v CoUKf-P-Y GeoAudit ❑ <br /> Clien' <br /> Sample Location Sample Type <br /> Number Description Date Time Water j Solid No. of <br /> Air Conts. / Notes <br /> 1— X— i - 36110 <br /> ��j , l —_{ , — (,}•.i:o _ ----- ----- - I ` -- 36111 <br /> 36112-- '- - --- <br /> t� 36113 r ; <br /> - --- — —- --- — I <br /> e rnquis _ <br /> "T cc) oc we <br /> 9natur <br /> Dole/Time <br /> I <br /> ib rre) <br /> o b Slgnoture ��'�l�", <br /> J Dole/Time <br /> (Signature) / G�a G �iZs <br /> viceived by Mobile Laboratory for hold analysts; (Stgnaluro) �1�U�lL� `� <br /> Qats/Time <br /> Dispatched by: (Signature) Dale/Time Ileceived fvr Laboratory by: <br /> Dele/Tlme <br /> Method or Shipment: <br /> La story Name <br /> Special Instructions: <br /> nf f hereby autiloflze the erlormence of the above Indlcrted work <br /> GOOD CO iDMON APPROP`t ''...� Tir <br /> NERD SPACE ABSENT C0NTAINERS <br />