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M- m = - = mom m m m m m m m = I <br /> CHAIN OF CUSWY RECOR <br /> - . Geological Audit Services , Inc . � � 36,� <br /> - = E7ywonmentilAmmssiona/s Date � Page �.� of � <br /> —- NNW <br /> � 1803 West March Lane Suite A-Stockton,California-95207-(209)956 0264 <br /> Client - - T - Project Manager <br /> C o{'i r Q c�. - - Tests Required <br /> - - _ - Rob l"la <br /> - - - Rhone Number <br /> o�) q 56 -o2 <br /> Samplers (Signature) <br /> Invoice <br /> Project Name c rj c�V s `l ��'�' '"' `x� GeoAudit (� <br /> - - / Client ❑ <br /> - _ Semple- Location __ Sample TypeNo <br /> a� <br /> Number =_ Description - - Date Time Water Air Solid Cantst '� Notes <br /> - comp— Grab <br /> =— Mins _�3_- 10-19 - - 3--30-�{ f 5 X 3 x <br /> -- --- X <br /> -- D - _- _l�ru <br /> _ = D - <br /> r _ _ <br /> _ )ehnquis ed py (Signature) _ cc ived ignatur 1 E <br /> 51a t1Q q►"C] Date/Time <br /> - -1�e q ( atur <br /> ignature) ate/Time <br /> y obtle Laboratory for{i©Id analysts (Signa •S• <br /> a. dat o <br /> Dispatched by (Signature) Date/Time Received for ry <br /> __ D e/Ti <br /> me a <br /> - Method of Shipent 9 6 <br /> _— — - — <br /> Laboratory Name <br /> = Special instructions --_ w �' S + <br /> I hereby authorize the performance of the above indicated work <br /> - - NE-58 QA/QC <br />