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G CHAIN OF CUSTODY RECORD <br /> Geological Audit Services Inc . r <br /> Environinen/a %ssion,7/s ' Date 'I `f Page l of ) <br /> _— 1803 Weat March lana, Suite A Stockton, Calilunn(l � 7;,'10/ ('llltl) :1',6 U%GA <br /> \ ------------------------ ---- <br /> Client �JOr}1� 11C�se� Proiect Manager <br /> ---- -----_--- -- -_-_--- C)�ej Iy VVTests Required <br /> Phone Number ------------ / <br /> Samplers: (Sigat <br /> nure) / Invoice: <br /> Project Name �e plate GeoAudit�`] <br /> i Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time _Water _ Solid No. of ; <br /> Air Conts. Q / Notes <br /> Curnp. Grub.... <br /> r)"\T <br /> --- <br /> i <br /> ,r^ <br /> -AelenQ a y: rgnalur -- - - r•----- - -- --- - -- ---- — <br /> n-ucuivoa 1)-y-1 (,,u�n:uuru) � Oale/T'me <br /> ,�}2YiC�2rc� -7 q <br /> Quished by: ignature) ------- — - - .._..- Gf'GE <br /> Ilucuivor >y; (Signature) yl <br /> Oat /Time <br /> •linquish d by: (Signatur _ <br /> r bo ulory for lietd nnalysis� (Signah'n�) Date/Time <br /> Orapat:had by: (Signature l)utu/Time ]Recelved for Lu ux fury by------- -- <br /> ( Date/Time <br /> Method of Shipment: I` <br /> Laboratory Name^ <br /> Spec al tnatructiona: — ---------- Yy611- <br /> I hereby authorize ttre performance of the above indicated work. <br /> ) t Y I ( I 1 1 t 1 I ! 1 t t t 1 4 1 <br />