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Geological CHAIN OF CUSTODY RECORD <br /> gical Audit Services , Inc . � _ <br /> ;--T= Enilrronmenta Professionals Date :-1 y <br /> Page of <br /> 1803 West March Lane Suite-A Slocklon California 95207 (209)956 0264 <br /> Client <br /> f rf Jc+^d p v-y Protect Manager <br /> 80�- Mur � Tests Required <br /> Phone Number <br /> (,oq) qs6-o),b '-I <br /> Samplers (Signature) 2�\ <br /> } Invoice <br /> Project Name � 'i''U O rl �pct I �_51q�� <br /> 1G" wtc� '^^' �,h GeoAudit [� <br /> Sample �, Client [] <br /> f Location Samf�le Typr, 0- <br /> Number <br /> Number Description Data Time Water Solid No of �' Q <br /> c�rr,n crap Air Conts /�Q Notes <br /> 50260 <br /> 50261 <br /> 50262 50262 ' <br /> 1 <br /> �'�inQ my ,e y rgnatu�rfa, <br /> e G V B y i p n a t u ro y � <br /> El[{L�bCi<. �- `I _ Date/Timo <br /> nahngyr hed� (Sipnalura) f 1 _ �S <br /> L Jacor ed by Signaluro) S 3 <br /> 75�? � �J , � DalelTrme <br /> Relrnquished by (Signature) <br /> — —~— R wed by Mobile Laboratory o d analysis JS,gnalure) <br /> Date/Time <br /> pispalched by (Signature) l]alalTirna <br /> ftoceivad for Laboratory by <br /> Date/Time <br />� <br /> Method of Shipment <br /> rn Lahoralor Name <br /> y <br /> VQl`� te1�t r. l�lt T! `La pbf <br /> Special Instructions -��7 �-,� <br /> 1r [VT 4' PrIm �;Y� �- --1 �+ I hornhy authorize the parloimnhce of ilio rihava indicated work <br /> G40C i i lf►r,_ FRQiL <br />