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(� CHAIN OF CUSTODY RECORD <br /> eoloPlaOlOSSAi7iIca Audit Services , lnc . Date 11-�a-Q3 Page of <br /> : . <br /> w �7� EnYir0nfnentVIV <br /> 1803 West March Lane. Suite A• Stockton, California•95207-(209)956.0264 <br /> Client ris COIIJV"q CO. Project Manager <br /> 14 4„l n M`K, b& Tests Required <br /> Phone Number / <br /> Samplers: (Signature) .�,1 / , Invoice; <br /> Project Name JVoacj� PL(mP , wf '�tltf /�, ��� /GeoAuditt. <br /> Client ❑ <br /> Type <br /> Typ , y <br /> Sample Location SampleNo. of � >� ,���,��� C} <br /> Number Description'' Date Time Water Solid � Notes <br /> /� <br /> p Comp. Grab. Air Conts. � <br /> 11-11 tH x X ; 3�3� '°4 J <br /> T 2t Iqq v x X X <br /> 4 <br /> T'N 115:00 k <br /> .S r '. !. 5 ratl��i�* 'Sou�M 3. Y0 � �73dr, <br /> 5P —1 111"C14041, Ivor? X. >1X 332" <br /> r Cn s e slur ece va y: (Si aturo «: •Q�- <br /> d d T ARWiti .T. : <br /> qulshed by: (Signa re) Received y: (Signature) f 1{a4 a INC 1cu 4 r QA /Q Dale/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date rime <br /> Dispatched by: (Signature) DatelTirne Received for Laborato b <br /> n y: Date rime <br /> Method of Shipment: Laboratory� Name 14 C C u xi jlr <br /> Special Instructions:. ririp I hereby authorize the performance of the above Indicated work. <br /> lip— <br /> u Gt J - <br /> GOOD C DMON 400 APPROPRIATEIMSPAC <br /> -- <br /> OOWAINERS ftw <br />