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SIS CHAIN OF CUSTO Y RECORD <br /> Geological Audit Services , Inc . Date u-17~c3 Page of <br /> Environmanta/Profmss na/s <br /> 1603 West March Lane, Suite A-Stockton. California-95207-(209)956-0264 <br /> r <br /> Client f���� �.k k7 y- <br /> Project Manager <br /> Tests Required <br /> Phone Number <br /> Samplers: (Signpture) PD Invoice: <br /> GeoAudit ❑ <br /> Project Name rT5 'b` A r-t 15,T 5 ho Client ❑ <br /> e <br /> Sample Type <br /> Sample Location Date Time Water Solid No. of Notes <br /> Number Description ------- Air Conts. / <br /> Comp. Grab. <br /> >v{ -- —Cf� 3-0 fl f <br /> 7-q3 <br /> 1`�erY ��3 �W — 7— q3 fit. 3:30, j t <br /> ye inquis ecl�y: ( r�gnaal ,e/) Received by: (Signature) �r Date/Time <br /> L',..r'! /,� -s _ ^�✓c�v� t , �I � I tF-�l��S 7 l S�F3 <br /> natur � Qate/TimeRelinquished by: (Sigyee <br /> Relinquished by: (Signature) Received by Mobil Laboratory for field analysis:(Signature) Date)Time <br /> I <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: DatelTime <br /> Method of Shipment: Laboratory Name <br /> I <br /> I <br /> Special Instructions: I hereby authorize the petformance of the above indicated work. <br /> I <br /> I <br />