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� - CHAIN of CUSTODPRECORD <br /> =� Geological Audit Services , Inc . Date ; 1 err Page , Qtr <br /> V taw <br /> low 1803 West March Lane, Suite A- Stockton.Calilornia-95207-(209)956-0264 <br /> s.� <br /> G S N3 <br /> Project Manager <br /> Client C>; - r. ili{r� i�tve ,, 1 9 <br /> < < ."iri i .t 11,, E tch I Y Tests Required <br /> /7 <br /> Phone Number <br /> C.) wl ) .1 ,, 6 o 11;7ill <br /> / , / ; <br /> Samplers: (Signature) - � ,- Invoice: <br /> Project Name (> t' k1V f 11, �' <br /> �� ,t, .., 1.r r;1; <. ° IJ GeoAudit ] <br /> Client ❑ <br /> Sample Type , o <br /> Sample Location Solid No. of <br /> Date Time Water #<�.� Notes <br /> Number D <br /> Description Air Conts. <br /> Comp. Grat). <br /> 34866 <br /> i <br /> t { <br /> I <br /> e 1nquis a by: ignaiure eceive y; ignalwe <br /> Date/Time <br /> Relinquished by: (Signature) Reeir dib . (signature) Dale/Time <br /> Relinquished lay: (Signature) e'i d by Mobile Laboratory for field analysis: (Signature) Date/Tim <br /> Dispatched by: (Signature) Datef imeReceived for laboratory by: Dale/Time <br /> Method of Shipment: Laboratory Name <br /> -1--- rl�ti � 1, t � <br /> 5pocial Instructions: I hereby authorize the perlormance of the above Indicated work. <br /> nnODIUMN <br /> �r <br /> "NSPACEMSMU. cow/V <br />