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CHAINOFO <br /> F CUSTvOY RECORD <br /> �_� Geological Audit Services , Inc Date age'N•= E17V%rOnmenla Pro%ssiona/s <br /> Of_L <br /> —ONLAOr1803 West March Lane, Suite A- Stockton, California -95207 -(209)95f,-02x,4 .:•1t�'�� (tib,;:;,.1,�Gb� �' <br /> Client D L(- M^N_F__S Project Manager <br /> g T is Required <br /> /0 tilt/u-t t SUu— U.1.1 g-- OVt aAJT_0 J7 Phone Number <br /> 'v 2-6 y <br /> Samplers: (Signature) <br /> / Invoice: <br /> Project Name MA`I49JR-S - Lot� � `� r21t4,4,� GeoAudit � <br /> `� Client <br /> Sample Location -- - Sample Type <br /> Number Description Date Tillie —Water Solid No. of / <br /> — <br /> Comp. Grab. nt( Conts. 0 � � /- Notes <br /> �" 3 I�Nt� �cctv�rroN. z8 s->o-��- ►�=�s <br /> x - <br /> --- - ---- - ---- ----- _L X <br /> • I <br /> Ir o: 5 <br /> -------- I T� <br /> 1 m rushed by: (Sr nature) <br /> inq�y: ( ignalurre) --- ----- 1=-1�_ L -- -•----...._..__ _ �rl — ` S/ No/ilme ,____ <br /> teceived by: (Sipnaturc) <br /> onto/Time. <br /> Relinquished by: (Signahrin,)— � — —"• Received by Mohile Lnhorotory for field analysis:(Signature) <br /> Oal Time <br /> Dispatched by; (Signature) Dale/rime Ilocoivod for Laboratory by: <br /> Dale/Time <br /> Method of Shipment: <br /> r r UU ,; ,. <br /> 'LaboratoryName ML.r� ('IHER <br /> Special Instructions: �l•I.11. i.�� r rr tR'--� <br /> APPROPRIATE hereby—��-• I hb authorize the performance of the above Indicated work <br /> rnp[� •l;ri011�� <br /> I IFAD SPACE ABSENT CONTAINLR��__- ----- -- ----_--- <br />