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CHAIN OF CUSTODY RECORD <br /> =� <br /> Geological Audit Services , Inc . oats 11- � ?-� Pae 7 <br /> ter= EnVlmnmenla/PloleSSlonalS 9 2 <br /> w 1803 West March Lane Surto A Stockton California 95207 (209) SSG 02G4 <br /> 9 <br /> r <br /> Client ��k P11 ��� 5 Project Manager <br /> )5aL M 4�-� Tests Required <br /> Phone Number <br /> (a4 �� 6 01.� '�� <br /> Sampler, (Signature) ��- /Invoice <br /> Protect Name �ack4farq �� GeoAudlt <br /> Client ❑ <br /> Sample Location Sample l ype � <br /> Number Date TLITH W.11e.r - -- -- So <br /> lidNo of �/' .� <br /> Description �- — t - 4 fit, Conts ���� / / Notes <br /> 7 2 7aK}� trapc� <br /> e rn unshed b xk- - <br /> ':e'v <br /> q y ( rgnature n t (]ate�Sime <br /> Relinquished by (Signature) Li� t�T�n tire) Dateflime <br /> Relinquished by (Signature) rlc Lzborata for Ira Id anal srsY Y (Sigrinhuc) Date1'Trme <br /> Dispatched by (Signature) ollrrno Rn<< 'Ved Im t-ibormory by Date rime <br /> Method of Shipment Laboratory Name <br /> Spacial instructions F—ons -- —- ----- ------ <br /> I hereby authorize the performance of the above Indicated work <br />