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F— r-- r-- r-- r-- r— r- r— r-- r-- r— r-- r-- r_ r.' r" r--_ r..-- r--.' <br /> A" CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . Date _ age __,�, of <br /> a — En�ironmenta Proless�Ivna,Qs <br /> •W <br /> teOLAW 1003 West March lane,Suitt A•Stockton, California•95207•(209)956-0264 <br /> client USDA — SC-5 Pr ect Managef <br /> � Tests Required <br /> Phone Number / <br /> A5 <br /> rs� Si natur � ' <br /> ( 9 ` Invoice: <br /> Project Name U. <br /> 9 Client�"'� i i�GeoAudit <br /> Sample Type , <br /> v ❑ <br /> Sample Location No• of <br /> Solid <br /> Number Description Date Time Water Air Conts. i Notes <br /> Comp. � Gr3b. <br /> � r <br /> 17V 3 $-/G 31817 <br /> - - 1-. .._ ._ <br /> N"A9 <br /> 3Iza �8t9 <br /> t <br /> , 3� <br /> 3f,,- kD <br /> C ; <br /> '.( is nature) Recerve y: - nature Date/Time <br /> -;a ingws ed by: (Signatur Received by: (Signature) Date/Time <br /> relinquished by: (Signature) Received by Mobile laboratory for field analysis:(Signature) Date/Time <br /> _Dispatched by: (Signature) Date/Time Received for laboratory by: <br /> Oats/Time <br /> tethod of Shipment: , 11 Lab tory Name <br /> 0 b G OTHER /WoC'✓¢ 13��C--- <br /> pecial Instry�x ^O�D�ON �� 1 hereby authori he performance of the ove indicated work. <br /> ijbJ l� ._1C APPROPRIATE <br /> I► O , <br />