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CHAIN OF CU TOD CORD--, <br /> Geological Audit Services , Inc . Date -LS• Pae ' ' <br /> � <br /> E17114taN &M.7 Profess1naEs 9 of' 1803 West March Lane, Suite A- Stockton,California-95207-(209).958.0284 <br /> r <br /> Client Pro'ect Managet TSS Required <br /> Phone Number <br /> samplers:,(Si nature) / /. /Invoice: <br /> � � � } GeoAudX <br /> Project Name [.BTW�.l '/ ; i i/ Client ❑ <br /> Sample Location Sample Type No. of <br /> Date Time Water Solid ' Notes <br /> Number Description Comp. Grab. Air Conts. <br /> P1 wr 15, 747 <br /> f` ' <br /> ,E <br /> Bet in he by. tgnature a we y: lure) �� ^ t � C{aO ims <br /> Relinquished by: (Sign ure) Received by: (Sign ture) i L//,ham //Date rime <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) DalelTime <br /> Dispatched by: (Signature) DatelTime Received for Laboratory by: Date/Time <br /> Method of Shipment: Laboratory Name <br /> Special Instructions: I hereby authorize the performance of the a ova indicated work. <br />