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CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . c;)5 F'41 Date Page � Df <br />� _ -�' EnYironmenta Professrona,(s <br /> iw:dW 1803 West March Lane, Suite A-Stockton, California-95207 (209)956-0264 <br /> M <br /> Project Manager Tests Required <br /> Client d (� oTe j - - M til - Ca f L�q S r�t Bob Marl <br /> P.0 Box 55- 103 Phone Number <br /> 7�oq g5b-o�6� <br /> S Tock)ow CA g l? 0 5 Samplers (Signature) � Invoice <br /> /eoAudlt ❑ <br /> '� V4 -'.ThC / Client <br /> Project Name l''� t d -C� , �.Qa 9; K9 � � <br /> Sample Type No of <br /> Sample Location Date :T:tme Solid Q Notes <br /> Number Description �—Water <br /> omp crab Air Conts �� <br /> Mw- 1/10-19 -q3 iaK <br /> Mw�3l�o-I -a3 <br /> i a ignature) ecei y (Signature) Datelrime <br /> its <br /> 5?p�dard T-i4 T- �8 49111 <br /> Plaa1+ FTI A*04115 Date[Time <br /> Relinquished by (Srgnature) Received by ignature) <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (signature) Date/Time <br /> Dale/Time <br /> Dispatched by (Signature) DatelTime Received for Laboratory by <br /> Laboratory Name <br /> Method of Shipment <br /> Special instructions i hereby authorize the performance of the above indicated worst <br /> ..r■ ttttttttt>ta � ■� � � � � � 1♦ � � � � � �� � � <br />