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== � <br /> Geological Audit Services inc . CHAIN OF CUSTODY RECORD <br /> �..� Date gage i of 3 <br /> -En'Vifwmenta Pmfess�tonals <br /> $803 West March Lane, Suite A- Stockton, California-95207-(209)958 0264 <br /> 22,74A-3 <br /> Client 5�o �� �p� 5ev� 5 �ayia ProK1e- VM✓ta1'�r'14i �7�1e q <br /> Tests Required <br /> Phone Number / <br /> �4q ) 9 15- 6 —0 )4 t-) , 'c j / <br /> Samplers; (Signature) / /i Invoice! <br /> Project Name wt N i V, ln,'l.c� �'1 h� ; 'GeoC edit <br /> a <br /> Sample Location Sample Type No, of �a <br /> Number Description Date Time water Solid q . , Nates <br /> p Com Grab, Air Conts. <br /> Sou'IEv•H� _ t <br /> 5 ! " RQ � 5loc1�1 w•tif yr41 3~��,.q� I �T:3U 49 cc1*troy"'J.0 51 1 to <br /> w-' <br /> W41 1 X43 l <br /> t+ [ 05! � 5 1 ^5 1U <br /> 5 1 w-0tiT y='�G 4916 <br /> Gowtp <br /> 5 (t h/orlh� <br /> ^ W-11 �ir�� I �i <br /> M Mo el y 't1c I <br /> +�951 5`i 4 nn <br /> in urs e ( rgnewre ece`ive y: igp ture✓ 5 1dNC Q►"C� �� r�.T DatelTlme <br /> rnquished by: (Signature) Received by: {Signature) Date/Time <br /> Relinquished by: (Signatu(e) Received by Mobile Laboratory lot lield analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipment: y ..'�i)h �+ � ,�:c I} 1 �pj-"It It 0'i Laboratory Name J <br /> I ��`�`•-q- �Yi'1�Iti'fT9 � � � rp F'� l.Q WI�bF� f <br /> 2 <br /> Special Instructions: r f+n/1� ': r i1�Cl� �' thereby authorize the performance of She above indicated work. <br /> l7A �—=,r, 1! t� <br /> HFA S�ltf'�ADS r <br />