Laserfiche WebLink
= Geological Audit Services Inc . 3 2- <br /> Ay Page <br /> CHAIN OF CUSTODY RECORD <br /> Date y P g —L— of <br /> jP EI7VIM 7MM1.71 Pf0fess10na/s <br /> I low <br /> 1803 West March Lane,Suite A Stockton, California 95207 (209)956-0264 <br /> Client Project Manager Tests Req/1% <br /> b ��t <br /> Phone Numt�er <br /> q'QG Cis <br /> Sa !p-ker�s�(Slgnure �� ice <br /> , �y "� 7 C,(_h it 1K <br /> Protect Name [r� � 1`--1�2� t ❑ <br /> Sample Type <br /> Sample Locatloi No of Notes <br /> Date Time Water Solid Q <br /> Number Description Comp Grab Air Cants <br /> i m I3 4)e//-Z �q-�s Imo' X Z 7- <br /> Pw 3/3 zq-aa 3 i J7 <br /> i �Amw-yakil LOW I ?Q 94q 1 13 <br /> Relinqui,oha ig lure ecceeiive y 1 ature Date(Fime <br /> Ir 12ZI <br /> Relinquished by (Sig ature) 3 U"`� Received by ignature DaterTlme <br /> 3o91rOa <br /> Relinquished by (Signature) Rece1v'ed—b—y'9&iJLL&IToratoryf <br /> held analysis (Signature) Date[TLme <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DaterTime <br /> Method of Shipment Labbo t�o Name <br /> s <br /> Special Instructions I hereby uthonze the performance of the above indicated work <br /> lr <br /> 4 <br /> v <br />