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c r r r r r r r I r r r r r r r r r r <br /> CHAIN OF CUSTODY RECORD, <br /> Geological Audit Services , Date Inc . ,� - �g-g3 <br /> ---�„`� I Page 1 of <br /> =��- EnVironmenta/Professionals <br /> � <br /> 1803 West March Lene, Suite A•Stockton,California-95207 -(209)958-0284 <br /> r <br /> Client {o Project Manager Tests Required <br /> �u <br /> P 1r ct ®ob 1tdr1�/ <br /> Phone Number <br /> 2.01 - q56-0,7-6L-1 <br /> Samplers: (Signature) <br /> Invoice: <br /> � •yk,� ,�,� /` /� /GeoAudit <br /> Project Name Kp(1d PV0P*0,/ Client <br /> Sample Type <br /> Sample Location No. of <br /> ater Solid Notes <br /> Date Time W ��" <br /> Number Description Comp. Grab. Air Conts. <br /> Mw-( lir-lq- X - -33260 . yx <br /> 3Mw- <br /> �.,�,.s.... <br /> I l d fo 0. F651 ;w, A •s,l 9 n a l y 9l 5 (11",i_� •� y�J <br /> rn urs a y: ciure) eceive d y: rg ure 5 fptrlCl4NC) '.4.1 <br /> oatelTime <br /> s✓ �� / '�� 1 <br /> nquished by: ( ignai fel Received by: (Signature) P j�Q�� J M(I u 4 �Q DatelTime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by; (Signature) DatelTime Receivod for Laboratory by: DatelTime <br /> Method of Shipment: Laboratory Name <br /> 6"/ M C Cq 040 Aha! 2 l c g r <br /> Special lnstructlons: VLOAS a&O MM3 OTHER I hereby authorize the performance of the above indicated work. <br /> lor-rra sale <br /> GOOD COMMON MO�d v APPROPRIATE <br /> HEAD SPACE ABSENT.— <br />