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CHAIN OF CUSTODY RECORD <br /> Geo � <br /> IOra�ic�al�Audlt Services , Inc. Date page z o,_2-- <br /> INSAW 1803 Went March Lane,Suite A-Stockton,California-95207-(209)956.0264 <br /> CY S f <br /> Client F-1 l4 hor t, Co(4oJ,,y C 14 Project Manager Tests Required <br /> 90b M ) <br /> Phone Num r <br /> 0-05 ) a5-6-26 <br /> Samplers: (Signature) {� Invoice: <br /> Project Name F !K ho r h Cou"liv G f g b %k A'.'" GeoAudit <br /> � lierrt <br /> Sample Location Sample Type - <br /> No. of <br /> Date Time <br /> Number Description Water Solid Notes <br /> Comp. drab. Air Conts. K, <br /> u.j- <br /> A <br /> Mw3- 3 � 13 _ )5 x ! : 40730 =, <br /> Mw I - 30 <br /> Mw3 r5'- 11 o L• D <br /> MW3-Wo x <br /> Relinquished by; (Signature Koceived by: (Signature) Date/Time <br /> Relinquished by: (Signature) by: (Sign <br /> ate Ime <br /> al a b <br /> Relinquished by; (Signature) Received by Mobile Laboratory for field analysis: (Signature) le/Tima <br /> Dispatched by: (Signature) bate/Time Received Ior Labo.alory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> rr 5 r K- Cr��� A t,led Seale . .f.. +. ► �T' `Ca �,� <br /> Special Instructions: x ► ll!$':' 1 hereby authorize the perlormance of the above Indicated work. <br /> GaMCGN A-0 <br /> v � yWr. <br /> NFk SPACE ABSENT]ilia*_ C0NVJNN` . <br />