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—� � �.. ttttittl. w � �.■ ..� � � s G� � �� � � � <br /> CHAIN OF CUSTODY WORD <br /> sem. eological Audit Services , Inc. <br /> EDate "I _qPage of <br /> lea" 1803 Y,lesi March Lana, SII <br /> -te A-Stockton California-95207 (209)95"264 <br /> I <br /> s <br /> Client Bt t 1 5 ).e w<r7� Project Manager <br /> 30 b Ma r T,f Tests Required <br /> Phone Number / <br /> Samplers (Signature) / Invoice <br /> Project Name 5 1 e w a Y�` 5 3 e a C o GeoAudlt <br /> Sample <br /> Locationf Sample Type �hi��� Chem ❑ � <br /> NumberDescrDNo % f �/ <br /> 1ptrort ate I Time Water Solid <br /> o o <br /> comp Grats Arr Conts /A`/ Notes <br /> r �r <br /> q- s r f X X2147 f �� <br /> 5 _ 3 I <br /> f f <br /> JIM <br /> �� <br /> 5 y }Z"lAM1w <br /> e inquishey +gnature I ry <br /> ecerve ignatur <br /> l,���✓ <br /> tehnquished by (Signature) (� <br /> Received b (Signature) <br /> I 7 <br /> 41 vt r( t t1�Q Oateo ime 't <br /> lelinquislted by (Signature) I <br /> Received by Mobile Laboratory for field analysis (Signature) <br />� �Vo/Time , <br /> hspatched by (Signature) uatei I ime Received for Laboratory by It <br /> Hate/rime <br /> lethod of Shipment i <br /> PQM Laboratory Name <br /> penial Instructions <br /> M'Caw( ba {j <br /> U�riJI hereby authorize the performance of the above indicated work ) <br /> UnJ &�7 O� ll���� ���� Vin' IJ�, / s <br /> GOOD CONDITION ,app —�P_!' <br /> t` <br />