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IM <br /> asy� CHAIN OF CUSTOD ECORD <br /> Geolo ical Audit Services , Ince Date - - s3 Pae of i <br /> �c- g <br /> E17Virenmenta Professi0nais <br /> 1603 West March Lane, Suite A-Stockton, California-95207-(209)956-0284 <br /> M <br /> Client s—S Project Manager <br /> Tests Required <br /> Phone Number <br /> Samplers: (Signature) Invoice: <br /> A2T 21 7�7 r� i Ge C{edit A <br /> Project Name G� �'J V ❑ <br /> f / <br /> Sample Type <br /> Sample (Location Date Time Water Solid No. °t / Notes <br /> Number Description Comp. Grab. Air Conts. <br /> 90 7v w <br /> 10 07ilMcrnr WAV L /k, Z <br /> /pAU)7 - fo0-7g3 Jlotbt-j WUL, $ 7 5 <br /> jtMus— I - r o e'g q3 JVc t, 3 <br /> 10 0? 13 M0,_� Waw 13 <br /> Jo,Lu -4 --to 07 q3 tJ4r•J W4 _ #-G}- 3 <br /> qu``he by: (Signature) Received by: (signature) UaielTime <br /> T"� <br /> Relinquished by: (Signature) Received by: (Signature) date/time <br /> Relinquished by: (Signature) Received by Mobile Laboratory for field analysis: (Signature) Date/Time <br /> Oispatched by: (Signature) Oale/Time Ret iv for aborator by: ate/rime <br /> Method of Shipment: Laboratory Name <br /> Special Instructions: I hereby authoriz a performance of the above indicated work. <br />