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f CHAIN OF C <br /> - � US�vOY RECORC <br /> Geological Audit Services , Inc . <br /> owe _ lr -g� Pa , <br /> 0 SKI T Ennroninenla Pro%ssionaLs i Page d <br /> - 1803 West March Lane, Suite A-Stockton, California-95207 -(209)956.0264 <br /> ww- <br /> CI-rent p S Project Manager <br /> gD M cw-p Tests Required <br /> Phone Number <br /> (2-o9 ) 9 6 6 <br /> Samplers: (Signature) �� mice: <br /> Project Name Pq y r i 5 S �4p,(,w, ' lt'-7k4'u � GeoAudit (X <br /> Det 5 f �-qoi rliLteir ct <br /> Client ❑ <br /> Sample Location Sample Type No. <br /> Number- Description Date Time Water Solid ,/ Notes <br /> --C.-Inp. Grab. Air Con s. `'` / <br /> 5P - 510CAPiIt i`QjT- 17:30 X <br /> S P 'Z 71"4 - w.57 1,3 '3! X <br /> I <br /> e quis ed ( ignalu _ 5ecwe ignature) <br /> S 7 a �1 d a�� T.]� .�• DatefTime <br /> Relinquished by: (Signature) Received by: ( i lure} <br /> Date rime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) <br /> Date/Time <br /> Dispatched by: (Signature) Dato/Time Received for Labor at y by: paleRirne <br /> Method of Shipment: <br /> Laboratory Name <br /> Geur�b►- 5 C1 V' Pr- <br /> Special inatruclions: <br /> I hereby authorize the performance of 1he above Indicated work <br />