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�_ I• Ili Mill 11� <br /> 7V0 <br /> CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc , <br /> Date -j3 ���~ 1 <br /> �� EnYironmenla Professio�a/s Page of <br /> tiNow wa� 1609 West March Lane Suite A Stockton California 95207 14- (209)956 0264 <br /> r <br /> Ghent I3) 1 1 5 re w u r l Project Manager <br /> 13oY Marl. Tests Required <br /> Phone Numb r <br /> (-;taCl) 9 h 6-0,1 Erb <br /> Samplers (Signature) �;�r Invoice <br /> Project NameVa , ,�� �iju� ,�� GeoAudlt50 <br /> Client ❑ <br /> Sample Location Sample Type oh <br /> Number Date Time No of <br /> Description Water Air Sallt� Conts �� Notes <br /> i- Gump G.nh� , 1 <br /> t <br /> ilk W,rl, �)'wr6r r�l�d,.y z-q-q�- 11 17 I X 1---5 0263 <br /> rt N— 1 VeAot.11, 1;'w+,r <br /> N 30'13 w-sr 1 +% I.1-zv x 1X I 50266 <br /> I <br /> — } Weyl V.,11 'scirj t, 101 / j�-D � �( � X :__—5-0-2-6,7 <br /> " W - X 3 f5auj t, ; 12- 3 <br /> 10� x I <br /> l — 50260-- ,L <br /> W 3 ry 5crt1i0; r1� ti1 I l 502f�9 <br /> I f <br /> e.nquu tie �y ....lure ocorve I I <br /> ..nature <br /> T <br /> JdV4QVJ �- f� � - Date/Time 1V <br /> Ret.nq�shed by (Signature) eeew d by /S.nature) <br /> �r �j/ Dale/Time <br /> Rel.nquahad by (Signature) Recd ed by Mobile Laboratory for held analysis (Signature) <br /> De191Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by <br /> Dale/Time <br /> tt"t ir' f 7. <br /> Method of Shipment Laboratory Name <br /> Special Instructions lv <br /> l ielfti <br /> C�1i�i+�� � <br /> I hereby aulhor170 the performance of the above Indicated work <br /> C � � <br /> HEAD SPACE IA<����, <br />