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CHAIN OF CUSTOdWECORD <br /> Geological Audit Services , Inc . --�9� Date S - 1 ) _q Page 3- of 2 <br /> �-� En�iranmenta Professionals <br /> 1803 West March Lane Suite A Stockton California-95207 (209)956 0264 <br /> Client Q Pq rY'1 s h 501 5 <br /> Project Manager <br /> Tests Required <br /> FobM gYT` <br /> Phone Number <br /> (--�-o9 ) 9 !6 -o. <br /> Samplers (Signature) �{'/ Invoice <br /> Project NameGeoAudrt Ix <br /> Pa r r s d- S p 5 1 g o S M► e►^ lisp. '7M,�2�,c�,.�a-+� o-� Client <br /> Type Typq <br /> Sample Location SampleNo of <br /> r <br /> Number Description Date Time Water � Solid Copts �� j , Notes <br /> Air Comp Grab <br /> S P M;� V3 j 3 5 <br /> i <br /> e quashed (Signatu I eceive ( ignature) <br /> r r n y15� c! ,za— 574 da+�� T 19 Datefrime <br /> Relinquished by (Signature) Received by ( i Lure) DatefTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Datefrime <br /> Dispatched by (Signature) DatefTime Received for Laboratory by Date/Time <br /> Method of Shipment Laboratory Name <br /> 5 al"Mor <br /> Special Instructions I hereby authorize the performance of the above indicated work <br />