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40 -*O\'-ho" 001"�HAWOFMTMWI RM <br /> Geological Audit Services , Inc . Date 10-7�g-g3 page t of z <br /> �� Enw1w1ne►nta P1vA9SS a78& <br /> 1803 West March tans,Suits A-Stockton.California-95207-(209)958-0294 <br /> r <br /> Clientc Project Manager Tests Required <br /> h Cam b� J1[ KQV)K M`K# bb: <br /> Phone Number <br /> (201) 1S6- o;L0 <br /> Samplers, (Signature) Invoice <br /> Project Name 57ot~MtK Rvk 57g7ito �, 1 rj /' �� GeoAudEt ❑ <br /> Client (IQ <br /> Sample Location Sample Type No of fC� y.' .�� <br /> Number Description Date Time co Wateerrab Air Solid Conte � �� IL° �q -1—Nates <br /> 4 <br /> P - I D�4tU+ny.v PAM to�8��3 le�L4s X I X x x X 32857 <br /> 5 P,- I it <br /> TaKw aXlo3 tt� 3S l X X XX ` 32$58 <br /> `r ). — E TaKI4 oz , Fa3i evt� I z 0 h ( X X X x 32.A5A___-___. . <br /> `I' �. 1 S 41 V%.4d Ie- 2AA[l_ <br /> T �. - 1� t well e 14 1 �. �(7 X X X x f 326fi � �Jf <br /> V Y <br /> T 3 — E Taysjk 0� Ea4 e"01 17- * to x /` rl I 32862 1 <br /> 5 P - 1 5Tocl4plje ,Td�� os I I - �4 X 32863 ' <br /> ell nqu e a y gnaturelftcoledygnat <br /> 1012 70 <br /> )" <br /> f <br /> flet nqu shed by (Signature) Received by (Signalure) DalelTlme <br /> Relinquis a by (Signature) Received by Mobile Laboratory for field analysis (Slgnatute) D+talTim• <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Data/Time <br /> Method of Shipment Laboratory Name <br /> n ate/ tiC-C4m ilrtI <br /> Special Instructions +gyp n-* OM t hereby authorize the performance of the above indicated Work <br /> 1 �1�1�i V Q <br /> .r.t <br /> GOOD CONDMON APPROPRIATE <br />