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tttttttttt� tfttttttififl! �� � � � i■■! � � � � E♦ � E♦ � � � � <br /> CHAIN OF CUSTO RECORD <br /> _ Geological Audit Services , Inc. Date�-'1�- f page 3 f3 <br /> EnK1WMenla P101LMionls <br /> a <br /> 1805 West March Lane, Suite A-Stockton,California-95207-(209)956-0264 <br /> r <br /> ' Client S K Project Manager <br /> Mom rt ue vi Tests Required <br /> 6 N. EL buz-"b S EeT Phone Number <br /> zv� gS�-oatp� <br /> 7' Samplers (Signature) Invoice <br /> Project Name ��,tjs � �� 5 GeoA <br /> Client <br /> ent ❑ <br /> Sample Location Sample Type -��•,`G�i <br /> Date Time Water Solid No of //1 Notes <br /> Number Description J Conts 4' <br /> Comp Grab <br /> Z-)Y-IY I C3 t x x <br /> TT <br /> He quis by (Signature) Tcewed y afore oatefrime <br /> Relinquished by (Signature) �'��� �49 J-eSv 1-4.5 r <br /> Received b (Signature) <br /> Norrv1"( -TA:-r, DatelTrme <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Oatefrrme <br /> Dispatched by (Signature) DatelTrme Received{or Laboratory by <br /> Oatefrime <br /> Method of Shipment Laboratory Name <br /> gP"&Z:12 <br /> Special instructions I hereby authorize the performance of the above Indicated work <br /> t <br />