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F <br /> v T' CHAIN OF CUSTODY WORD <br /> =� , Geological Audit Services , Inc . gate - x `� '` 3Page � of�L - <br /> �7 F1W1Vnmenla/Pro1essilynats <br /> �-� 1803 West March Lane, Suite A Stockton, California 95207 (209)956 0264 <br /> ' <br /> � �] 0 D(� <br /> ClientProject Manager <br /> (' �vt c V CA. Bq �4 V. E Tests Required <br /> Phone Number / / <br /> Samplers (Signature) /invoice <br /> Project Name (2 rt 111 0 V u Rq R P vr 9k✓ i�?/� /GeoAudit <br /> Y ° Client ❑ <br /> Sample Location Date Time Sample Type Solid No of / / ,'/ Notes <br /> Number Description comWatGrrab Au Conts <br /> e ingwa e y (Signature) Received y (Signature) Data/Time <br /> Relinquished by (Signature) Recery by (Signature) D telTime <br /> C~ 9 3 /X 6 <br /> Relinquished by (Signature) Re eived by Mobile aboratory for field analysts (Signature) DatelTime <br />� I <br /> Dispatched by (Signature) Date/Tine Received for Laboratory by Datefrime <br /> Method of Shipment Laboratory Name !' <br /> Grit kouvtd 8,15 CctISCleoCP LQ o,- tIt, ta5 <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />