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fes"' e , CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . 7 <br /> "V EnV1f0nmenla Pro1essiona/s Date Page f, o I <br /> F 1800 West March Lane, Suite A•Stockton, California-95207-(209)9565.0264 <br /> 5 aa� <br /> Client14er" Project Manager <br /> S 1-16 r17 Tests Required <br /> Phone Number <br /> S m lers: (Signature) Invoice: <br /> Project Name ACU Gea Audit <br /> ClientM— <br /> Sample Location Sa .ale Type <br /> Number Description Date Time - Water Solid No. of U Nates <br /> i Corn p. Grab. Air -00 ts. �� - o -- - - - <br /> 7 <br /> . , <br /> ZI <br /> iwo <br /> l <br /> f:z3 I X � kxk <br />. to uis� alure `�•'3 Z ±� tx <br /> ecetve y: igna e) <br /> ellnquished by: (Sig .lure) <br /> Received by: (Signature) <br /> Date(Tims <br /> Relinquished by: (Signalum) Received by Mobile Laboratory for field analysis: (Signature) <br /> Date[Tima <br /> Dispalened by: (Signature) UatelPime Received for Laboralor b <br /> III y: Dele/Time <br /> Method of Shipment: <br /> iiil.l"' i i) r•;, -. _ Laboratory Name <br />' Special InstructlonG�aQ cGNQ�iQ�� - " ���, � -•• "" "` <br /> U .–rV0- P Ropp, ►iTF I hereby authorize She per of the above indicated work. <br />