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� � � l• � � 1• s• � � i s 11� 11•��`tit>� �� � �■ <br /> CHAIN OF CUSTODY RECORD <br /> ^ � Geological Audit Services , Inc . Date —eo-92— Page > of <br /> _ =E7 E17]14=17enta/Professiona/s <br /> 1803 West March Lane Suite A Stockton California 95207 (249)958-0264 <br /> Ali— <br /> Project Manager <br /> Client , �� Tests Required <br /> c �l <br /> 0 . �-� ' Phone Numbers / / <br /> ZOq) 4F!;-& <br /> ��]�,( :a-)'f,� OMIVTI A Samplers (Signature) Invoice <br /> GeoAudrt ❑ <br /> Project Name g D�Sr�r�U-PAJ( iZ Client <br /> 5 T k�� <br /> f <br /> Sample Location Date TDI;iie Water <br /> Type Solid No of `/k� Notes <br /> Number Description Comp crab Air ContS A / <br /> I <br /> M►v-z q-ro v if 'z ( -�a - z1.110I 3 <br /> e In is 't, gnature) Receiv nalure) Date lT me <br /> y> ?� ��l� <br /> Relin4ui ed by (sig azure) � � <br /> eceived by (Signature) ! LS � r�X �+/ iJatefr+me <br /> Relingsished by (Signature) Received by Mobile Laboratory for field analysis (Signature) p ) �O�Dv Date[Time <br /> Dispatched by (Signature) DateMme Received far Laooratory by l / ! Date1"rime <br /> Method of Shipment Laboratory Name <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />