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ri f C r <br /> 4C- CHAIN CHAIN OF CUSTODY RECORD <br /> Geological Audit Services , Inc . Date �Ir-9�1 <br /> Environmenla/Prolessiona/s Page �` of <br /> 1� <br /> 1803 Wast March Lone, Suite A-Stockton,California- 95207 -(209)356-0264 <br /> Client 51141 M q ; pros!u CT 5 To C . Project Manager <br /> — f� e t., >} M c Tests Required <br /> Phone Number <br /> ( oq ) q5 6 -0)- 6 Al00 <br /> a° <br /> Samplers: (Signature) <br /> � Invoice: <br /> Project Name 7%c � h 4% a GeoAudfl <br /> v / Client <br /> Sample Location Sample Type o/� <br /> Number Description Date Time Water Solid No. of Notes <br /> — c0cm-1- crab Air Conts. tl L <br /> B -- fC) GYrut I �LV�f1 � � 'ft-9 I <br /> - -_- -- -- 7 g- -- ---- -- x OW- o <br /> r✓ r� � — I y V o rr iW�U 5 7 L— V ' �0 4 <br /> - - --_ x X 030 S <br /> -- -- o_?a 61 <br /> -- Nola r•'�oi►4iy <br /> 5awiplt for pos7- 1+1 ; <br /> -- - - w CT ir �gd <br /> eink`gw,hed t;-y(S flnalurc) riecowod ri- <br /> _I Dale/7 ime <br /> —Iing in,hcd�2,. /�/P'.+� / , lC-� _ �. 5 7Q Ddu r� T-R-T <br /> Relinquished by: (S+gnatureJ -- �7't� Q��,y,�� <br /> deceived by, (Signature) <br /> • Qate�Time <br /> f;ciinquished by: (Sic�natura) Roceived by Mobile Laboratory for lield analysis: (Signatura) <br /> Date/Time <br /> Dispatched by: (Sic3neturc) Dale/7rtne —f—Laboratory by: <br /> Qate/Time <br /> Method of Shipment: <br /> Laboralory Name <br /> Special instructions: boll - F} <br /> 1 hereby authorize the performance 01 the above Indicated work <br />