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_ CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . <br /> Date <br /> _ E17Yiror�menta Profession/s , `�1 Page l of <br /> 1009 Wael March Lane, Suite A-Stockton, Calllornia-95207 •(209)950-0264 <br /> . — Sao+ Asss pro <br /> ClientProject Manager <br /> rYG G Tests Required <br /> t FLp�--� Phone Number !�-1 <br /> ar <br /> II <br /> Sam lens: (Signature) Invoice: <br /> GeoAudit <br /> Project Name E]Client <br /> Sample Location Sample Type ' <br /> Dale Time Water Solid <br /> . QI <br /> Number Description Notes <br /> Comp. Grab. Air Con S. <br /> 1 -7 <br /> JAJ <br /> 44 : <br /> F <br /> 112. <br /> R !� y: ature aocoi ,�by: ignafuru <br /> Date/7ime <br /> 7vin�!wrrh,4b I <br /> z:Io y: (SignaturefDatefTime <br /> 3.36 <br /> Retinguished by: (Signature) aivod by Mobile Laboralory for field analysis: (Signal ura) Date/time <br /> Dispatched by: (Signature) Delo/Time Racoivod for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> Special Instructions: <br /> r rye � <br /> I hereby authorize the <br /> performance of the above indicated work. <br /> L SA(� <br />