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CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . Date 7- 1 - 33 Page 1- 00 <br /> _ <br /> Envimnmenta/Professionals <br /> 1803 West March Lane, Suite A- Stockton, California-95207 -(209)956-0264 C).� <br /> ClientProject Manager <br /> Bart 1� off' S)e C-hloh /417.1 hr, 3ohn U rrtd 1 ict Rob McOV Tests Required <br /> F-0- Phone Number <br /> 54CM oh n <br /> Samplers: (Signature) �a `pp Invoice: <br /> Project Name Ma r n a (3�o`F k PvS �"ut�t"'� 'I2tc 7��cs-v� a. `� , GeoAudit ❑ <br /> s Client <br /> Sample Location Sample Type No. of <br /> Number Description Date Time Comp.at crab. Air Solid Conts. �' Kr/ / Notes <br /> 61 - 30 6-;L3•7 X I X <br /> 8 - 30 X ► X <br /> F33 — 30 Y IX <br /> Relinquished y: ignature ec edy: ignature Date/Ti e <br /> 51 <br /> Relinquished by: (Signature) Received by: (Signre) Date/Time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laborato <br /> ry by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> Sea Y �V <br /> Special Instructions: 1 hereby authorize the performance of the above indicated work. <br />