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� � i i• � i• i• � � �A ffff�■ i tit �� err+ <br /> CHAIN OF CUSAY RECORD, <br /> -� Geological Audit Services Inc . �• <br /> w 9 Date 6-/x'9¢ Page I of I <br /> EnVironmenta/Professiona/s <br /> �•! <br /> 1803 West March Lane Suite A Stotklan California 95207 (209)956 0264 <br /> ClientProject Manager <br /> �2v o 4 Tests Required <br /> Phone Number <br /> ?.� 95-&-021-0,+ <br /> Sam <br /> F rs (Signature) Invoice: <br /> Project Name 1UK4e-i0Y GeoAudit � <br /> Sample Location Sample Type No of <br /> Number Description Date Time Water Air Solid Conts Notes <br /> Comp Grab <br /> 4 <br /> • <br /> e inquishe by (Signature) ece� ry i ure) <br /> Date/Time <br /> Relinquishedby (Signature) cd ( n ure) J�f2 , .l,�} DateMme <br /> } Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) duM�W Datoalme <br /> Dispatched by (Signature) Date/Time Received for Laboratory by i DatelTlme <br /> Method of Shipment P Laboratory Name <br /> owd G.d.L <br /> Special Instruotrons I hereby authorize the performance of the above indicated work. <br />