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Elpz �=' f CHAIN OF CUSTLY RECORD <br /> _= � Geological Audit Services , Inc . // r <br /> �~ El7 rnnmenta Prnlessiona/s Date Page —2, of �- <br /> .��►�. <br /> ~� <br /> NNW 1603 Wes! March Lane, Suite A- Stockton, Cefilornle •952b1 -{209}956-0264 <br /> r <br /> Clients Proj. ct Manager <br /> �� Tests Required <br /> MCA�02- r¢t, Phone Number <br /> 20 <br /> Tir (Signature) Invoice: <br /> Project Name / /I ��� � �� �/ GeoAudit <br /> Sample Location Sample Tyke Client <br /> Number Descri Date Time Water _ Solid No. of / 'lT i/� ,/ <br /> ption W — _ i / Notes <br /> Comp. Grafi. - Air Cows. <br /> - ------------t -- <br /> -F�ehnquis e by: ( ignelure eC v y ( i lure ' <br /> 2k" Dett ,- <br /> /1 Fm <br /> l�gti i vishe b): gnalure} r ~�� �i a^Q1� �•riT= �� <br /> Receiv d b Signature} <br /> -�- r - '� DatelTimr <br /> elin uished �/� <br /> 4 y: (Signature) RLrceived by tie ile Laboratory for field analysis: (Signature} <br /> 061elrime <br /> L <br /> Dispatched by; (Signature) Date/fur Received for Labornlor h <br /> r y: <br /> beteflime <br /> Method of Shipment: <br /> Labotattory Name <br /> Special Instructions: <br /> 1 hereby aut 01126 the perlormsnee of the above Indicated work <br /> r�- <br />