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r C <br /> CHAIN OF CUSTODY RICORD <br /> Geological Audit Services , Inc . jiz <br /> :. E17Y/rol M,'171a ProIOSSI0na/s Date Page _� of <br /> _ "V <br /> ow 1805 Went March Lana Suite A Stockton Galslernia 95207 (109)95G 0,164 <br /> � a <br /> Client j�a�I�k� VLI l r� Project Manager <br /> Tests Required <br /> Phone Number E <br /> Samplers (Signature) Invoice r <br /> Project L o t�2fW Fri c oVx � u `�°" GeoAudit JM <br /> Client ❑ <br /> ample Location Sample Type <br /> a� <br /> Date Time Water Solid No of �� <br /> Number Description Air Conts Notes <br /> Coma Gr-;I) <br /> x z X <br /> Mw-5-/11- -z �5F 7 <br /> Relinquished y rgnalure aco4by <br /> atu ` y - _ Date/Time j <br /> 1� z'L S�ct�� u rct r r 1I, j7-d Iq: L t <br /> Relinquished by (Signature) na ura) Dale/rime <br /> r <br /> Relinquished by (Signature) nocarvod by Mobsle Laboratory for hi.ld -inaiysis (Signature) Date/Time <br /> Dispatched by (Signature) Dato/lima Hocoived for Laboralory by Date/Time <br /> Method of Shipment Lnbornlory Name <br /> _ w F51 <br /> Special Instructions --- <br /> I haraby rruthonao Iho porlormance of the above indicated work <br />