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tft> >_ r >• Ellam 1• M = � <br /> CHAIN OF CUST RECORD <br /> `-� Geological Audit Services , Inc . Date- s- page 3 <br /> �� EnY�ronmenta Professionals <br /> 1803 West March Lane Suite A-Stockton California-95207 (209)956 0264 <br /> now <br /> Client L.! SILO Project Manager Tuts Required <br /> morru Dave t/t n <br /> '7D6 EL Dp s7Tjz c�r Phone Number <br /> GDC QA 5 LO Z Samplers (Signature) Invoice <br /> Project Name L'4a.¢.Y S �� PR�2 j� � _ ,� �e��LJ �,�� / GeoAudlt Q� <br /> U"""", Client ❑ <br /> Sample Location Sample Type No of /V <br /> Number Description Date Time Water Air Solid Conts o �\ /� Notes <br /> Camp Grab <br /> X33- N,� -11-01'f <br /> 3-55 i-�rq '1 3,�.5 ; ?� <br /> l ! - ! 0 r_ I' <br /> J <br /> i qurs e y (Signature) Receive ySignature)— DalefTime <br /> Ro /54 _S^yr <br /> Relinquished by (Signature) Receive by (Signature) /l Oatefrime <br /> Relinquished by (Signature) Received by Mobile Laboratory for held analysis (Signature) Datefrime <br /> Dispatched by (Signature) DatefTime Received for Laboratory by <br /> OatelTime <br /> Method of Shipment Laboratory Name <br /> Special Instructions i hereby authorize the performance of the above Indicated work <br />