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4r =01�- "NJ <br /> CHAIN OF CUSTODY ECORD <br /> -� Geological Audit Services , Inc . D � �_��,�� Pay l <br /> =7,� Enr� mer�ta ProfessA�nafs g of <br /> pr <br /> r <br /> 1803 West March Lane, Suite A- Stockton California-95207 (209)956.0264 <br /> �' <br /> Client &.4 f, Q �����o ��� Project Manager <br /> QO 6 m q vh l Tests Required <br /> Phone Number <br /> t;`o9 ) W6 -0261-1 <br /> Samplers (Signature) r11Gec <br /> Invoice <br /> Project Name , �h ' c � Audit <br /> Client ❑ <br /> Sample Location Sample Type <br /> Number Description Date Time Water Solid No of /�r,� / / �� Notes <br /> Comp Grab Air Conts <br /> r� <br /> Relinquished by (Signature) A <br /> gnature <br /> OatalTime <br /> R shed by (S nature) gna ure) q�II s~ 1Z <br /> Relinquished by (Signature) Received by ile La oratory for held analysis (Signature) <br /> Dat Rima <br /> Dispatched by (Signature) DatefTime Received !or Laboratory by <br /> DalefTims <br /> Method of Shipment Laboratory Name <br /> i <br /> �4D Awt �1 cct <br /> Special Insirucbons I hereby authorize the performance of the above Indicated work <br />