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CHAIN OF CUSf�.IJY RECORD <br /> Geol-ogical Audit Services , Inc . 3� � <br /> Date__g `f r` 9 y Page L <br /> _ —•: EnWronmenta A1v1essiona1s <br /> _•� <br /> 1809 West March Lane, Suite A-Stockton, California•95207-(209)956-0264 <br /> r <br /> ClientProject Manager <br /> D•�� . a v r; 5 w 5 o rn 9 o( M q i,-1, Tests Required <br /> Phone Number <br /> 0-09 ) 9 6 - 0,;. 6 -J <br /> Samplers: (Signature) .tom Irwoice: <br /> Project Name _ GeoAudit 14 <br /> M i v) e r ' �"'� M'c XC41?' ' Client ❑ <br /> Sample Location Sample Type <br /> Date Time Water Solid Na. of ��`: i Notes <br /> Number Description Air <br /> R I Comp, Giab. <br /> U [ _ 17 �YGq✓ct�iD� �D��iM E44r � -1!'q4 � �. '• ly <br /> j 1 1� ! i lip � �'a1i � 17"� �•� <br /> Soul L' <br /> 5 2 l3 i) 5aa'f•�wf1j U.pS 1 =� O t <br /> ;n�quished <br /> hed ( ignatu eoeiv by: ( ,gnature pale/lime <br /> by: (Signature} Received by: (Si nalute) i <br /> X"� fA gL,_/� ` DalefTime <br /> t�'�Vf�r/�1 ChP'11=L-1'f w�tiTf � q <br /> Relinquished by: {Signature} ll� Ll <br /> by Mobile Laboratory for field analysis (Signat're) DatefTime <br /> Dispatched by: (Signature) Dalef'rime Received for Laboratory by: <br /> Dale/'Time <br /> Method of Shipment: Laboratory Name <br /> ll <br /> i�9b C0u (/ tC}^ 5 ,0.V 0�- <br /> Special Instructions: I hereby authorize the performance of the above indicated work. <br /> ?, <br /> -t t%V-LZ, <br />