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I <br /> CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . Date. <br /> L <br /> `= EnYironmenta Plofession.?Is Page of <br /> v--- <br /> BMW <br /> �� 1803 west March Lane Suite A Stockton California 95207 (209)956 0264 <br /> Client $, 51 R ,u N 7 Project Manager <br /> 601,1 M"IV I V Tests Required <br /> Phone Number <br /> (�,(,�1 ) 'I t)G- 0?G � <br /> Samplers (Signature) <br /> _4y Invoice <br /> Project Name vV c1t,J S Quu covt ��' -f �� GeoAudit <br /> o-G Client ❑ <br /> Sample Location Sample Type `, �� N <br /> Number Date Time Water Solid No of <br /> Description Comp Grab Air Conts ,� Notes <br /> MW — I / <br /> M w-3/cl _q <br /> e inquis a by inature <br /> 7 8 starve y ignature — -- � Date/Trme <br /> f'I�c 1�tltcluNd l -A I- <br /> q/J7=00 <br /> Relinquished by (Signature) Received by (Signature) <br /> _ Date(rrme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) <br /> Date/Time <br /> Dispatched by (Signature) Date/Time Received for L bt <br /> tory by <br /> Y <br /> Date/Time <br /> �� <br /> �-� <br /> Method of Shipment l Labors ry Name <br /> 600 V cI i Q o N,t r a t o at <br /> Special Instructions I <br /> I hereby authorize the performance of the above indicated work <br /> I♦ � � � � � � � 1, � i � tib r� !� t!1 �ttttt� <br />