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r c c { r nn ca� r r rr r. <br /> CHAIN OF CUSTODI# RECORD <br /> _ <br /> Geological Audit Services Inc . ; <br /> �. Date �'" 3 Page l of <br /> .. Enr'imnmenta Prolesion.?& <br /> 1803 West March Lane, Suite A- Stockton,California•95207-(209)956-0284 <br /> r <br /> Client Cc( ry, V Ll Project Manager TSS Required <br /> —13'.1.7 11f r 1 <br /> Phone Number' <br /> Sam Pers: (Signature) /i <br /> A � g ? ,� / Invoice: <br /> Project Name ��4i Ji", ,V I V ';; ,;,.�,� "?i.�:r i� i .j�,,t /^y��'" /�� 'GeoAudit <br /> r r Client <br /> Sample Type r <br /> Sample Location — No. of <br /> Date Time Water Solid Notes <br /> Number Description Comp. Grab. Air Conts. i,y <br /> / <br /> AVJ MA i LOR I5� i1-17 �f 3 x t 33247 <br /> 0 33248 <br /> I <br /> in uis ere Received ecerve y: i lure DatelTime <br /> inquished by: (Signal re) Received y: (Signature) ��� ��G�/J!L Q/�/�(i Date/Ti me z <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Dale/Time Received for Laboratory by: <br /> DatelTime <br /> Method of Shipment: Laboratory Name /J <br /> �Tl�'�L`fTT.Gf7,r- <br /> Spec al Instructions: WAS 0 � �G+ftlJ U 1HER I hereby authorize the performance of the above Indicated work. <br /> PR , G+l1! <br /> APPROPRIATE <br />