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0" / 7c7 <br /> CHAIN OF CUSTOD ECORD <br /> �_ Geolo ical Audit Services , Inc. _3Q_ <br /> E1W1VnM&7fa�P1Vf Y1017a& Date � �{ Page —L--of 1 <br /> mob" 1803 Wast March Lane Suite A-Stockton.California-45207-(209)956.0264 <br /> n� <br /> CllentProtect Manager <br /> 6 �4� ��'^ M ar� Uf e B010 �a r bTests Required <br /> Phone Number <br /> Samplers (Signature) Invoice <br /> Project Name Nrlowe P;eoptr* i kS IN / GeoAudlt K <br /> '•"[f'� ��n � // Client ❑ <br /> Sample Location Sample Type Na of <br /> Number Description Date Time Water qtr Solid Conts Notes <br /> Com <br /> hw3- 7� 01066M weV3 , 7yf,- )1 tS'3 '�"` <br /> MW 0 `75 T?oyFlortt� �fj��'� r 7� �'4+ F W10 <br /> ".mac <br /> M W 4 `1 hMR <br /> Fl; <br /> e I mquis �yl( gnatureReceived y (Signature) �{ } ; <br /> A<ph� slak aYd T1;! = Date 1h <br /> nit9t�-b• Ca i l0^� j t � � <br /> Relinquished by (Signature) R1 eceived by (Signature) <br /> Date/time <br /> � I <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) ! DatelTFme <br /> t <br /> Dispatched by (Signature) Date/Time Received for Laboratory by <br /> Dat trims <br /> Method of ShFpm nt /D ' <br /> L, � ' `n , _/� Laboratory Name <br /> Special Instructions ` n � � � I hereby authorize the performance of the above indicated work <br /> gs <br />