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=_ Geological Audit Services , Inc , c�!-iAfN OFCUST �Y RECORC <br /> ;V7 En�i�onmenta/Pro/asscna/s Date 4 Z Page �_ of ' <br /> v-- - <br /> 1803 West March Lano, Suite A -Stockton, California- 95207 -(209)956.0264 � <br /> tsi <br /> AS 56' <br /> Client JI Pro ect Manager t <br /> Tests Required <br /> Phone Number <br /> Z/wy T <br /> Samplers; (Signature) -- ,%�� �j /(nvoice: - <br /> Proiect Name PA-Y � L G p 1 I '¢�� / / / / / /GeoAudit i <br /> / 9, <br /> ^� � Client ❑ <br /> Sample Location Sample Type � <br /> Date --- No. of dotes <br /> Number Description 1 lime Jvater i Solid <br /> Comp. iii lh`-� i�llr Cont$. j' � <br /> t r � <br /> 35376 t <br /> t <br /> t<Iocoi ed Fly: (�inaf J n -- —� _ <br /> uls <br /> � � <br /> etinquished by: (Si n rc <br /> g ' ) Itecoived b <br /> y: (Signature)•, / �G <br /> Daterrime <br /> Flutinquishod U --•- —.-- -- _ �d�/�� <br /> y: (SignaWre)� f7oroived by hAobilo labonitay for 1iolr3 annly:is:(Signaturol) -w''G':::�'� ,J�.+i ce.% <br /> Cr- �-�� . <br /> Daterrime <br /> Oispatchod Uy: {Signature) Ottul7unu - �1t0CAJIVnul Lrr lnbui;Uor t; <br /> Y� Datelrimo � <br /> 1 <br /> tAothod of Shipment: � •��`��JTTri., <br /> Laboraaiottyy�Naammee , <br /> Spacial tnstruction3; <br /> rZ <br /> 1 horeby authorize the porlormanco of the above indicated work. <br /> ..J1VTi.itlEr�,; <br />