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r r r r r r r r■ r r � .�■ �. tllll� <br /> CHAIN OF CUSTOIJOECORD <br /> Geological Audit Services , Inc . Date y- —page —L— of I <br /> _ _=_=_ En��ronmenta Protessnonals <br /> '1803 West March lane, Suite A Stockton, California 95207 (209)956 0264 <br /> project Manager Tests Required <br /> Client }L r S 13 41-f <br /> phone fJ'dqNumber <br /> Any lz:;)O#� J 64"174- Sampler (Signature) Invoice <br /> GeoAudlt ❑ <br /> Project Name plslCT7�� Client.ff <br /> �LA <br /> Sample Type No <br /> Sample Location Solid of °f Notes <br /> Date Time Water Air Coats <br /> Number Description Comp Grab <br /> pa- -rs-y u�cw � -�s la3s� X 3 <br /> DalefTime <br /> eceive y ignature7p,,,jj,�1� �Relinquished y �gnature �r <br /> ` n/i✓l.c - DatefTime <br /> Relinquished by (Signature) Recarred by (signature) <br /> (Signature) Date[Time <br /> Relinquished by (Signature) <br /> Date/T�me Received f ra b)I D eMine <br /> Dispatched by (Signature) �ff <br /> Method of Shipment LaboratName <br /> I hereby aut ize p formance of the above Indicated work <br /> Special Instructions <br />