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CHAIN OF CUSTO RECORD <br /> Geological Audit Services , Inc . Date �t-a-a Paye of—L <br /> — =.. _ EnYimnmenta Pm1�ss�iona,(s <br /> 14 fe VM 1803 West March Lane Suite A-Stockton California 95207 (209)956 0264 <br /> aw V <br /> AN— <br /> Client f�a 0 (b h wakf <br /> Project Manager Tests Required <br /> 50J malr1 <br /> Phone Number l <br /> Samplers (Signature) Invoice <br /> GeoAuda NI <br /> Project Name C 0 iV1 V>ra �'(�'+�I 'iW'Ir� �o Client ❑ <br /> a <br /> Sample Type �, <br /> Sample Location Date Time Water Solid No of �` Notes <br /> Number Description Comp Grab Air Conts <br /> o I -'40IN <br /> X <br /> e mquis e y (Signature) Signature) Dawnrne <br /> )� 66`n4py 1� S)atzdav7 T 117- 4-q3/16�k h i <br /> Relinquished by (Signature) Recei Date/Time <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) �DatefT�ime Received[o ry by a ime <br /> Method of S oratory Name <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />