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-- CHAIN OF CUST7RECORD <br /> -�-=- Geological Audit Services , Inc . <br /> —� Envl,,onmenla/Professiona/s Date 3 ' q h Page l of <br /> 1803 West March Lane Suite A Stockton, California-95207-(209)956 0264 <br /> NNW <br /> �c,2 <br /> Ghent J oz To ST t Protect Manager <br /> Bab NOTests Required <br /> Phone Number <br /> L�Loq) q.3,�--0.16q <br /> Samplers (Signature) Invoice <br /> Protect NameV m�r 1 i N A Gc o i- F a od /�} GeoAudlt <br /> Client [] <br /> Sample Type <br /> i Sample Location Sample <br /> of � <br /> Date Time Water Solid _Notes <br /> Number Description <br /> Comp Grab Air ContS <br /> / — 31,ah 3-3�� 1 t'30 3 X1 I <br /> MW-313- 3i-q:F- I - <br /> , y X 3 f <br /> i <br /> el+nQuis e y (S+pature) Re i natur Da711me <br /> Relinquished by (Signature) Received by (Signature Date/Time <br /> Relinquished by (Stgnalute) Received by Mobile Laboratory for held analysis (Signature) DatelTime <br /> + <br /> Dispatched by (Signature) Date/Time Received for Laboratory by <br /> Date/Time <br /> Method of Shipment Laboratory flame <br /> Special Instructions ,rL ! I hereby authorize the performance of the above indicated work <br /> G00C CClNUM11'' MOVE <br /> HEAD SPA,CEABSENr R+w CONTA <br />