Laserfiche WebLink
Geological Audit Services , Inc. CHAIN OFCUSTOD RECORD <br /> En14n17 Date z-r 7 Q i Page _of ) <br /> =•� <br /> 1803 West March Lane Suite A-Stockton, California 95207 (209)956 0264 <br /> i <br /> Client �pwe i�4 �a ��v21o �� Project Manager <br /> Rab ihar- X Tests Required <br /> Phone Number <br /> coq q9'6-0)4L/ o <br /> Samplers (Signature) V Invoice <br /> Project Name (� � M �1 �'��� / GeoAudd CR <br /> Client E]Sample Location Sample Type i�3/ / / <br /> ///-- <br /> Number Date Time No of h <br /> Description comp Grab Air Solid Conts Notes <br /> M - /z_ 7-q <br /> L 42 <br /> e inquished by ( rgnature) eceive y rgnalure <br /> - r Date/Time <br /> 2-!7•q- <br /> Relinquished by (Signature) Received r nature) <br /> 0 to/Time <br /> ..ra-..fit r res <br /> Relinquished by (signature) r <br /> Rec d y Mobile Laboratory or e!d nay Signature) ata me <br /> Dispatched by (Signature) Date/Time Received for Laboratory by <br /> 1)a Rims <br /> Method of Shipment m /7 �• y <br /> Laboratory Nae <br /> Special instructions <br /> (2 Po AN ly Ii cu <br /> I hereby authorize the performance of the above indicated work <br />