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- CHAIN of CUSTUD ECORD <br /> Geological Audit Services , Inc. 3C)o0 D;18 page of -7— <br /> =_ ` Envvrxurrerrta Prol�ss,+ana�r <br /> •1• <br /> 1803 West March Lane,Suite A-Stockton, California-85207-(209)956-0264 <br /> C{iem 6a„(C or �j 1�ck{rtC, { ja ,� (4ra {�,a— Pro7wct Manager Tests Required <br /> ( c;Te- L�`i-X"r& <br /> �• 6,rl /tic Phone Number <br /> 2Oct -- 0 <br /> Sa piers (Signature) Invoice <br /> ❑ <br /> Project Name GeoAudit <br /> $q 1 �. �� 6LV-(�� ,� Client <br /> Sample Location Sample Type �� f LocationNo c3! <br /> Number Description Date Time Water Salic � d / Notes <br /> p comp Grab Atr COnts <br /> -S Y <br /> Rall ws e , y 49 �tut e e y (Signature) D ta/Ti e <br /> Rahnquishe by (Signatute) Received by nature) Datelfime <br /> Reltnqutshed by (Signature) Received by Mobile Laboratory tot held analysis (Signature) L7atefTtme <br /> Oispatched by (Signature) Oate(ftme Recewad far Laboratory by Oatantime <br /> Method of Shipment, Laboratory Name <br /> i <br /> Special Instructions /,el/ sviA Ya SW�'r/ e4 - I hereby authorize the perlormance of the above indicated work <br /> 5 � �„� ���� c� � �rc s <br /> U't- �alet <br /> 1 <br />