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CHAIN OF CUSTODY RECORD <br /> Geoto ical Audit Services Inc. ,f-Ig-a3 pas <br /> Date 9 of <br /> Enyironmenla�Prote.ss iwaFs <br /> •� 1603 Wecl March Lane, Suite A-Stockton,California-95207-(209)956-0264 <br /> Project Manager Tests Required <br /> Client LIr CoKQloim H 6i Wv&­ <br /> Phone Number <br /> �.oq g5t�OX69 / <br /> Samplers: (Signature) Q,/ Invoice: <br /> t 4q/:I /GeoAudit <br /> Project Name Vo a c K Pq wt 1 '' � ` h�� � ,' Client <br /> Sample Location Sample Type Solid No. of :� ;i �! Notes <br /> pate Tlme <br /> Number Description Comp ra1eGrab. Air Conts.�h�',moo i �! t <br /> T� 3 Yat4�i'� �I ,zt' l I-lq�i1� l��lp X X i 33Z�9�x¢k,�'fi�r 'i <br /> Be nq s e re ecetve T, (Signature f .a e� Dale/Time <br /> i <br /> R nquished by: (Signal re) Received by: (Signature) QfA°f f lttA1 Q"l(�pt ( Date rime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date rime <br /> Dispatched by: (Signature) DatelTime Received for Laboratory by: DatelTime <br /> Method of Shipment: Laboratory Name <br /> 4,rti -/ 6{e C Cu.r.,/c�11 1 t P <br /> Special Instructions: 1 hereby authorize the performance of the above indicated work. <br /> u AS <br /> I EAD SPA(X ABqL:ENT._..._-_ "6NTA.jNEPS .-_-✓ <br />