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CHAIN OF CUSTO ECORD <br /> Geological Audit Services , Inc. Date 6-0 , --Z--page of <br /> WW Z-nWh .�naezta/Pro1ess1b17a& <br /> � law <br /> ;W — <br /> MEW 1803 Wast March Lane, Suite A•Stockton,California•95207-(209)958-0284 <br /> Project Manager <br /> Client IM Tests Required <br /> Phone Number V <br /> Samplers: (Signature) Invoice: <br /> GeoAuditJK <br /> Project Name �Zt AP--nsr� I R� Client ❑ <br /> Sample Type <br /> Sample Location Date Time Water Solid No.of �� Notes <br /> Number Description Comp. Grab. Air Conts. <br /> 4A -23 Il db 2' <br /> Z <br /> Relinquished y: ignatur eceive y: prature 1 Date/Time <br /> Relinquished by: (Signature) Received by: (Signature) DatefTime <br /> Relinquished by: (Signature) J Received by Mobile Laboratory for field analysis:(Signature) Dateffime <br /> Dispatched by.• (Signature) Date/Time Received for Laboratory by: Datefrime <br /> Method of Shipment: Labora ry N�e <br /> i <br /> Special Instructions: I hereb ho riz th e►forma of the above indicated work. <br /> II. <br /> i <br />