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i; <br /> CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . <br /> Date y Page of <br /> E-= EnVlmnmenla ProfeSSiolla/s <br /> 0110640F 1803 West March Lane, Suite A- Stockton, Calilornla -95207 •(209)956-0264 <br /> ClientProject Manager j <br /> Fra K 1 Cole Bab MtxrX Tests Required4. <br /> { <br /> Phone Number <br /> �zoq) g571 1� <br /> Samplers: (Signature) Invoice: <br /> Project Name Four (01AKRIn5 ?,(Q, �I / �_ _ GeoAudit {� <br /> Client ❑ <br /> Sample Location Sample Type 01 <br /> Date Time Water Solid No. of � Notes <br /> Number Description Air Conts. �q <br /> 7 7 Comp. Grab, Y <br /> 9,500 -0/ ca i <br /> 83 - 3 q�-tr — _ loioy <br /> B3 , 35' �-� <br /> O <br /> S - 71-5. bor�H W ysF�zi` � --oa �( f X <br /> e inquis a y: tgnature ecery e <br /> w shtl�d&"d T. T z3 if <br /> Relinqui h d by: / , 9Q+� 000 YQ ?� Nr <br /> R edture Dale/Time <br /> 10 <br /> LA� 110! <br /> e rs by: (Signature) Received by Mobile Laboratory for lietd anal sis <br /> Date/Time <br /> Dispatched by: (Signature) Dale/Time Received for Laboratory by: (' DatefTime <br /> Method of Shipment: Laboratory Name <br /> IRi1 — A <br /> Special Instructions: I hereby authorize the performance of the above Indicated work. <br /> ")l �r <br /> i <br />