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CHAIN OFCUSTODY RECORD <br /> Geological Audit Services , inn. <br /> _""—" Enviignmenta Professiov7a�ls <br /> � <br /> Date 'Z -Z' Page <br /> 1803 West March lane, 8ulle A•Stockton,California•95207•(209)958-0284 <br /> r <br /> r <br /> Client C— C!72: ,. Pro' ct Manager Ca <br /> �4 Tests Required <br /> Phone Number <br /> -"'? TCb —0 0� <br /> � S <br /> Samplers; ( i nature) invoice: <br /> a� l,� <br /> Project NameC jC�� /� �r��� �lZ <br /> �¢ GeoAudit �( <br /> Sample Location Sample Type � Q <br /> Number Description Date Time Water Solid No. of <br /> Comp. Grob. Air COntS. ��� Notes <br /> Vora, <br /> PREff <br /> !C T SG;'l�Tli�r i• <br /> W, M SPA T ALAE IT colt'ri iru:�S <br /> e mquis a y: ignelure <br /> Y til e � <br /> �, wV'/�•Y Oale/Tlme <br /> Re'n ish d b <br /> y ( igneture) Race d b Signal <br /> Relinquishe y: (St ature) <br /> ac Iv y Mobile lab razor for 11 Ida alyels:(8 nat re) <br /> �`f�/ f( t�L�`� �' Oate/Tlme <br /> ispatched by: (Signature) Lc <br /> Method of Shipment: Oete/T a ace ved L r tory by: <br /> Dale/Tlme <br /> fwd b C U rYlor Laboratory Name <br /> Speciallnstructlons: <br /> I hereby authorize the performanc of the above Indlcaled work. <br />