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rr� rtrrrrrrrrr� ttttrtttttt� � t� ism tIIIIIIIIIIR t• !� � � � � � i♦ � � � <br /> • O <br /> _=-ems Geolo icai Audit Services Inc . CHAIN OF CUSTODY RECORD <br /> 114—r — = Ent'ironm49MA Professionals Date �' ^Q�\ Page �L rr <br /> m..�... of____I_� <br /> �'� 1803 West Aiarch Lane Sulto A Slock,on Cahtarnia 95207 {209)956 0264 <br /> ✓fid' <br /> r <br /> Chane .3� 7&-2 - <br /> �j, l 1 5�.���,�-j-- Project Manager <br /> 00P H401 Tests Required <br /> Phone Number <br /> q 5-t- 0) <br /> Samplers (Signature) / Invoice <br /> Protect Name 5� vtraVJ 'S (I C on )4"- GeoAudit <br /> a� Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time camWater Air Solid No of Conts �aNotes <br /> 741APov� [� ptwa ��i�, yt9 ul�c 2-1q-11 li:oo k 3 <br /> Ta�t�� ' Sdc( ! 9-00 <br /> 50258 <br /> , <br /> ern uu e gUle <br /> ecer e y rgnalura <br /> Relrn uahed by (Signature) <br /> < ecer d by S nature) <br /> Date�Tlme <br /> ah quphed by rgnalure) Roc rved by Mobile Laboratory lot held analysis (Signature) <br /> DetelTrme <br /> Dispatched by ISlgnaiure) Dale/Time flocerved for Lahoratory by <br /> Date/Time <br /> Method of Shipment <br /> Laboratory Nam rr <br /> Special Intl jetiene 7 ' l <br /> luff �� F ESERVAT(i�f , w��. I hareby authorize the peflormance of the above Indicated work <br />