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_ 0 CHAIN OF CUSTOI <br /> RECORD <br /> Geological Audit Services , Inc . Date jt- 7 �-q page z of <br /> FnY1mnn7W1.71P1VfeSS1ona/s <br /> 1803 West March Lane Suite A Stockton California 95707 (709)95G 02154 <br /> Client �or� P� t lei 5 Project Manager <br /> Tests Required <br /> Fob M g r l <br /> Phone Number <br /> (a o q) � 5-6-0'z <br /> Samplers (Signature) �-� /Invoice <br /> Project Name �oCK-T, GeoAudlt <br /> a�3acoel ��l`''` ��� �� Client ❑ <br /> Sant ale T �c � * / <br /> Sample Location l _ YI �� / <br /> Number Description date Time Wake II Sollcf No of /J <br /> IO ---lGciriili— —6-r-111 1 Air — cont <br /> Notes <br /> 7 �. 7vNl�r V'0(.- rifiyt !t-)2-9+� fo'u <br /> e inquished by (Signature) lSeceiv Uy (Sign t - -- ------ --� Ual•/;Ima <br /> r�v, ..— 37 <br /> Relinquished by by (Signalurc) --- I elved by (Sign tire) — <br /> i Dale/;rma <br /> Relinquished by (Signature) deceived by Mobile laboratory for lield analysis (Signnlure) Date/Time <br /> Dispatched by (Signature) U-ilalTuno 7cuived I( Liboratoiy by Dale/Tlme <br /> Method of Shipment Laboratory Name <br /> Special Instructions I hereby auihorixo the performance or the above Indicated wort <br />