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—� CHAIN OF CUSTOD CORD <br /> Geological Audit Services , Inc . owe r' - 4.93 Page of <br /> En�ironmenfa Profess�na� <br /> 1803 West March Lane, Suite A-Stockton, California-95207-(209)956.0264 <br /> r <br /> +� Projeq Manager Tests Required <br /> Client �. ✓���, <br /> Phone Number <br /> Samplers: (Signature) , Invoice: <br /> Project Name {,, / ��.�� /^r' / GeoAudit <br /> Ciient <br /> v _ Sample Type! !« ' '�,� ,• j <br /> Sample I Location pNo. of <br /> Date Time Water Solidi Notes <br /> Number Description Comp. Grad. Air Cants. <br /> / r <br /> i r <br /> f <br /> �,r�,^- - r{5 '• y� I c,�� -tib 3 . 74 ,( � <br /> 30,, _/ J <br /> I• - - L�� � � � Z5 f <br /> e u is b ignature) ecerve y: rgnatura DatelTime <br /> Relinquished by: (Signaturo Received by: (Signature) DaterTime <br /> Relinquished by: (Signature) Received b Mobile Labor& or ield analysis: (Signature) Date(Time <br /> /1 i4 fT F•;b♦— <br /> Dispatched by: (Signature) DaterTime eceived for Laboratory by: Dale/Time <br /> Method of Shipment: Laha ratory Name <br /> Special Instructions: I hereb uthoriz he performance of the above indicated work. <br />