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Geological Audit Services , Inc . CHAIN OF CUSTODY RECORD <br /> = Envilonmenta/Proless1ona/s <br /> ~t.r►7r bate Page <br /> low 1803 Wast March Lnne Surto A Stockton Cnlrlorn11 <br /> 95207 (?ug)95G 02G4 <br /> ClientJ 7✓1 _ n _ I � Project man a or TR <br /> �ZY 1`L.t1 Tests Required <br /> Phone Number <br /> � Sar )lers +;Signature) Invoice <br /> Project Name/ � �K <br /> 1- �V- <br /> Sample Location Sam ale I yl-e <br /> Number Description Date Time �__ Waler _- Air <br /> Solid Co of <br /> Gon1P Gr rb nts Notes <br /> SP - 1slr..fe., 8 31- <br /> SP <br /> 3 !fie end ,s1 '15-b ---� 4 D 6 7 7 �-- <br /> e in is a by rgnature toc rvc b • <br /> nature) <br /> --t-- <br /> in e <br /> rn urshadrg�alura) �^ C A-7ZI +�� <br /> -7 - aCa 4 d by (Signator fr]1 <br /> / y \ a Oa1e/Tlms <br /> �Relrngwshod by (Stgnaturo) Lfr�r /a <br /> ocorved by Mobito Loborolory for hold nnnlysrs (Signature) <br /> Dispatched by (Signature) <br /> Untofirrna Oat•(Tlme <br /> Itncorvod for Lnbornlory by <br /> Dale[Tlm• <br /> r <br /> = Method of Shipment <br /> Laboralory Name <br /> Special Instructions �11� <br /> �r {1C + I hereby authorize the perlormano• of the above indloafed work <br /> s ICEJ1 <br /> PPRUPEWE <br /> r <br /> i <br />