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>_ �r�� rtittttiw �■■� tiiiiiiii� tintiiiiiwr tt�w tiiiiiiiii� � ,ate tttttttt�� tl�� ww■ ■■�■ <br /> �[ CHAIN OF CUSTOD CORD"""""""" <br /> ;_ Geological Audit Services , Inc . Date $- lg- g3 Page of <br /> -=w_— El7Virr�nmentaIRIVIOSSIOna/s <br /> �# 1803 West March Lane Suite A Stockton California 95207 (209)956 0264 <br /> W� <br /> r- <br /> Client 13a j 514wq vT Protect Manager Tests Required <br /> pab Mur) • <br /> Phone Number <br /> 7-09 4y6 -o;k6+-1 "N ' <br /> Samplers (Signature) /\ �' % / In <br /> } <br /> /GeoAudit <br /> Protect Name 5�t wQ � S $#Q c o h <br /> Cliennt ❑ <br /> Sample Location Sample Type No of <br /> Water <br /> Date Time Solid Q / Notes <br /> Number Description Comp Grab Air Conts <br /> MW9 - 10 <br /> Mwq- 15- <br /> 3 <br /> i <br /> einquis red y ( ig,/nattur_e Received y (Sig—nature) S Jq M d&f r Date/T <br /> ` me <br /> t';A 'I/,7'�'v`tr�"\ f J7 � t A r, �' �� <br /> Relinquished by (Signature) Received by (Signature) Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) DatetTime Received for Laboratory by Date/Time <br /> Method of Shipment Laboratory Name <br /> Alphot <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />