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i!Q� Geological Audit Services , Inc . CHAIN OF CUSTODY RECORD <br /> Dates•/3. 43 Page � of i <br /> Er:-57 &7Vironmenta/Pf010"iona(s <br /> Now 1803 West March Lane, Suite A- Stockton, California- 95207-(209)956-0264 <br /> Client Project Manager Tests Required <br /> r• O . Bio-x 11(o Phone Number 7 / <br /> �i7�G> /LJ� C<l 9SZo/ AT: VAU0 71,iil nature Samplers: Si <br /> P (Signature)) / / /invoice: <br /> Project Name ,yy,��,�/� Bio �. GeoAudit ❑ <br /> Client,�► <br /> Sample Location Sample Type <br /> p Date Time Water Solid No. of �� /j Notes <br /> Number Descri tion Air Conts. <br /> Comp. Grab. <br /> 17OM4fnc, W4u- IKAul3 �i3 //.'� X X, x <br /> by IV.E.S.T. <br /> da e <br /> i <br /> Fs ignatur eceive y: ignature Date/Time Rshed by: (Signature) Received by: (Signature) Date/Time <br /> Relinquished by: (Signature) 725 ��>r.Ofi//�/]— <br /> Received by Mobile laboratory for field analysis: (Si nature) _ � Date/Time <br /> C„_SCI � —G 7een <br /> Dispatched by: (Signature) Date/Time Received rbf L bo ory by �c <br /> � � Date/Time <br /> Method of Shipment: Laborat ry Name <br /> Special Instructions: <br /> I hereby aut rize the perfor ance of the above indicated work. <br />