Laserfiche WebLink
Al C. <br /> = <br /> Geological 110 CHAIN OF CUSTODY RECORD <br /> Audit Services , Inc. <br /> =��� Ern�irtanmenta Professanals - 1 -q 3 page 1 of 2 <br /> 1803 West March Lane.Suite A-Stockton.California-95207-(209)956.0264 Date-12 <br /> Client C q j d y-0 v1 r5 Marge I Project Manager <br /> blob M a r l� Tests Required <br /> Phone Number <br /> coq i156 -026f.4 <br /> Samplers: (Signature) "/Invoice: <br /> Project Name Lq(d ro h'S Mav xj,t . yc� �� /GeoAudit <br /> / Client ❑ <br /> ( Sample Location Sample Type h <br /> Number Description Date Time Water Solid No. of °►° �'r <br /> Comp. Grab. Air Conts./,`�� �� i / /" / Notes <br /> TP /11-3b <br /> -4 Ex cg vQ'�l 0 11'�6-9 3 16:0 o X 3 <br /> - <br /> SP— 5TccKp7lc Nr Il-1-y3 13:?0 I �, X <br /> SP- Z � 13:35— � <br /> � <br /> 5P-3 5 W 13:40 X l X K <br /> 5 - Sov�lh <br /> Wit 11-?o-q3 13: oo I X Y <br /> �1 <br /> E — Eas7 <br /> Wq <br /> W -- l W17 vVq 11 1 5,73 0 J< <br /> nqurshe by: ( rPnature ecerve <br /> y: rgnature <br /> � 7 � � � STa h d q►,d T.�,r- Oata/Tima <br /> Relinquished by: (Signature) <br /> Received by: (Signature) <br /> Dale/Time <br /> Relinquished by: (Signature) <br /> Received by Mobile Laboratory for held analysis: (Signature) <br /> Date/Time <br /> Dispatched by: (Signature) <br /> Date/Time Received for Laboratory by: <br /> Date/Time <br /> Method of Shipment: <br /> Laboratory Name <br /> Special Instructions: A 1 4 q <br /> 1 hereby authorize the performance of the above Indicated work. <br />