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rr �r � r rr r� r� r � r � r r �■■r r r r <br /> �q•�CHAIN OF CUSTODY CORD <br /> Geological Audit Services , Inc . Date1113-2 -Page of 1 <br /> - — �7,+ EnYironmenta Professtanals <br /> _� <br /> 1803 West March Lane, Suite A- Stockton, California- 95207-(209)956-0264 <br /> Client O � 1 Project Manager, <br /> Tests Required <br /> Phone Number <br /> �.O• �o� t � ( � � S-raGKTr�N, �� �S�o/ (709) �tS4 -oz�4 <br /> Sa <br /> lelr ( nature) �� // / �Invoice: <br /> Project Name V�,TECN LIQ \� �/ /eoAudit ❑ <br /> /i' / Client <br /> Sample Type <br /> Sample Location NO of <br /> Date Time Solid / Notes <br /> Comp. Grab. <br /> Number Description Water Air, Conts. �Q <br /> z- 3� t' a <br /> 9.46 X I �` <br /> $3 Zo lean u1el:.1- #-3 «-rz-12- Ia: /s X I <br /> e rnq a ature eaerve y: (Sign Date/Time <br /> - :5EX>i7 Ae3 7S 7z) a� i <br /> Reli uished b Si nature <br /> q y' 9 ) Received by: (signature) IWI FAX Date/Time <br /> J_ I <br /> i <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: <br /> Date/Time <br /> Method of Shipment: Laboratory Name <br /> r-�� <br /> Special Instructions: I hereby auth rize a performance of the above indicated work. <br /> 0; 'r -� <br />