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CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc. Date t� -s-�� Pae <br /> V Environments Professnona/s 9 of <br /> - 1603 West March Lane, Suite A-1 Stockton, California-95207 -(209)956.0264 <br /> �- <br /> Client {r�� Cq I d roll Project Manager <br /> j Q U�v l H C K i bk,P n Tests Required <br /> Phone Number <br /> tzoq ) q!4 -0,69 -� <br /> Samplers: (Signature) �V Invoice: <br /> F 3me Lu I JVOL6 MarVjic C64t. GeoAudit 14 <br /> o-h Client ❑ <br /> Sample Location Sample Type <br /> Number Date Time Water Air Solid Co.of � <br /> Description Notes <br /> Comp. Grab. <br /> ix-5-qy jd, ;L3 X 3 X' H 0 10 der posy;f^ P <br /> Mw- / 1.- t -q,-1 I E< <6 2 X <br /> 16 -1 X <br /> 5P t 7 51acl� le 1 r 5w 17.0 <br /> 7 I <br /> 5PI — g tint51? z - 7 5)IcKr' Ir 2 1 5 t y= X <br /> 5 P 1,15py,- 7 sV�-s <br /> r <br /> Arnquis a �y: rgna)ture ` t� <br /> I,�t�t1 Y )tit 1, eery y 51Qr1��laV`Y �'!1 �_ Date/Time <br /> eli quish • (Signature) �� -7'�)y <br /> ffec"�y (Sig D le/Time <br /> Z ' c <br /> Relinquished by: (Signature) / 11j7 9 <br /> Received by Mobile Laboratory for field analysis:(Signature) Date/Time <br /> Dispatched by: (Signature) Dale/Time Rocoivod lot Laboratory by: <br /> Data/Time <br /> Method of Shipment: <br /> VOS D&G I.ETN S OTHER Laboratory Name <br /> Spacial Instructions: Ieb ' ti t camd',I I <br /> GON GOtJDITIO�! APPROPRIATE I Hereby authorize the performance of the above indicated work. <br /> ) ) 1 ) ) 1 l 1 ) 1 ) ) ) ) l l ) l ) <br />