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CHAIN OF CUSTODY RECORD <br /> =� - <br /> Geological � � <br /> g cal Audit Services , Inc . al Date 6'�gg3 Pageof 2' <br /> EnV%rnnn7enta/Prclessrona/s <br /> 1803 West March Lane, Suite A- Stockton, California-95207-(209)956-0264 <br /> NEW <br /> Project Manager <br /> Client <br /> ahl� of 57ocMwi /Allh_ Mr. 3o4h Wrrul is 130b Mari, Tests Required <br /> PO. Aox I Il 0 Phone Number <br /> 57ocK)o+i , /� qs�.p i <br /> Samplers: (Signature) =� �� � Invoice: <br /> Project Name Mcteivlo ueolkers h ` '? <br /> y� � � o gGeoAudit ❑ <br /> / ^+ ,��/ igaO91 Client [� <br /> Sample Location Sample Type No. of �i� <br /> Date Time Water Solid '� o- i Notes <br /> Number Description Comp Grab. Air Conts.j q��Y j <br /> x x x <br /> B ^ zy 'X I x x X <br /> s7- _ �� X J x X x <br /> 62, - x x x <br /> � 3 x x X X <br /> F3 3 - z `7 X I x x <br /> R `i - ! o X I x x x <br /> e mquis a y: (Signature) ecerve y: (Signature) Date/Tiry e <br /> Yiyv MAIC �.!/ Slahc�arc{ T, A . T _ 6-}u-Y37l7: D5 <br /> Relinquished by: (Signature) Received by: ($i ature) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by: (Signature) Date rime Received for Laboratoryb <br /> y' Date/Time <br /> Method of Shipment: Laboratory Name <br /> Spa►- e� <br /> Special Instructions: I hereby authorize the performance of the above indicated work- <br /> "",,L'U� <br />