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: CH R <br /> `_ _ Geological Audit Services , Inc . CHAIN OF CUSTODY RECORD <br /> --=L <br /> = EnWrnnmenfaTProfessi01M& Date Page <br /> =, o{ <br /> � <br /> r 1803 West March Lano, Suite A-Stockton, California-95207-(209)956.0264 <br /> � <br /> �V <br /> Client �r !��Y,&7r Project Manager <br /> Pia X-/kL 1,_ Tests Required <br /> Phone Number <br /> - Sam lers: (Signature) Invoice: <br /> Project Name 77 GeoAudit <br /> Sample Location 5amp e hype <br /> Client ❑ <br /> Number .Description Date Time — Water Solid No. of �`� N <br /> Camp. Grab. Air Conts. <br /> 7` r P17- y e v�f Sz X >C � s <br /> :. <br /> f g��Mt t <br /> _�,ov.- ------ -----------�-- -�--- � - — - <br /> r <br /> e mqurs a y; rgnalure eeervc <br /> y: ( rgnol <br /> � OatefTl . <br /> erinqurshed by: (S nal re) Received by: (Signature) <br /> oatefrime <br /> Relinquished by; (Signature) Received by Mobile Laboratory for field analysis:(Signature) <br /> Dalefrime <br /> Dispalched by: (Signature) [)ale/Time Raceived for Labotator b <br /> y y' batefrinre <br /> Method of Shipment: <br /> V���;, �))''r•;; i Laboratory Name <br /> SpecialInstr : - . t:.St. r tip s. ^ ! ' � Z-L- <br /> GOOD CONDMON APPROPMATE -r I hereby authorize the performance of the above indicated work. <br />