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CHAIN OF CUSTODECORD <br /> Geological Audit Services , Inc. pie � Page of7 <br /> "'"'� Ern�rrtar�menla Professx�na.(s <br /> 14 11� <br /> `•� <br /> 1803 West March Lane, Suits A Stockton California 95207 (209)956 0261 <br /> Client a q Ificj 0 i 3)r 1 �L( I i i Project Manager <br /> 8 is� Md r Y Tests Required <br /> 1a.i k of 5 1.0 C K-I 0!0 Phone Number <br /> Samplers (Signature) a; Invoice <br /> Project Name 1 `1i '�`'t`��"�'' r?' GeoAudrt <br /> Sample Location SamDate Time —Waterple Type Sajid No of , 0 �7 <br /> Number Description Comp Grab Air Corpse �' / Notes <br /> �) w 'j/1-lq-g3 3'+? ly-3 7 <br /> Mw-� /3—I$ q3 <br /> Relinquished yignature eceive y ( ignature Date/Trme <br /> Xt-­, 41,14 � _Mslq'3 17 00 <br /> Aehnquished by (Signature) Received by (Signature) Date/Time <br /> Relm ignature) Received by Mobile Laboratory for held analysis (Signature) Dale(Time <br /> e y (Signature) Date/Time Received <br /> at me <br /> 0 of Shipment Laboratory Name <br /> Special Instructions t hereby authorize the performance of the above indicated work <br />