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=�— 'N"l- <br /> CHAIN OF CUSTODY RECORD <br /> �- Geological Audit Services , Inc . ,� aEnW17MetP /ssioa/s Date Page <br /> mo�r� of <br /> moor 1803 West March Lane, Suite A- Stockton. Calilornia-95207-(209)956-0264 <br /> r <br /> Client A y l' a`� f Project Manager <br /> Fob Marl Tests Required <br /> Phone Number <br /> (a��t y56 -o� ls <br /> Samplers: (Signature) �`�` Invoice: <br /> Project Name A y [o M i m l - MCI>nT p�� GeoAudit 14 <br /> Sample Location Sample Type <br /> Client ❑ <br /> Date Time Water Solid No. of .� <br /> Number Description <br /> Comp. Grab. Air Conts. Notes <br /> V/_ j1Q 7-t'-I q-)7 } l=fib 3 <br /> M W-a/a- 2 7-qy y 3 <br /> Mt/v-'3fq- 2-7-g9 <br /> ECEN ED •n� <br /> NE <br /> [. L : <br /> Relinquished y: (Signature) ecary y: nature f <br /> � � 17F;EELELs <br /> Qata/Time <br /> Relinquished by: (Signature) Receive : Sign 171 <br /> ,J / Date[Tirrip <br /> elin hed b `rZ 7 <br /> q y: (Signature) Received Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: <br /> Data/Time <br /> Method of Shipment: LaboratoryName <br /> Spacial Instructions: <br /> 'VV <br /> " <br /> I hereby authorize the performance of the above indicated work. <br />