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�.r� �� � �� eas �� a�Ar A � Ila, � tl• tib � t� � � tlf� � <br /> CHAIN OF CUSTOAECORD <br /> Geological Audit Services , Inc. <br /> —— •.• Ernmm�menta Prafess�nats <br /> Date 1�' 'Q3 Page _ of <br /> maw® 1803 West March Lane, Suite A Stockton California 95207 (209)956-0264 <br /> low <br /> r <br /> Client Project Manager <br /> v7 U/yaT� Irl C Ckfi r Vf h Tests Required <br /> Phbne Number <br /> Samplers (Signature) /Invoice <br /> Protect NameAyCo M t to; Md it t I&7 /eoAudlt <br /> Client <br /> Sample Location Sample Type No of / �' <br /> Number Description Date Time Water Air Solid `0� Notes <br /> Conts : <br /> Comp Grab , / <br /> vw-1/I;L-;1- g3lt-Azo l �•��-q 1���a <br /> VW- 111;'-;'I -q3 /1"0 <br /> F <br /> vial is ignature He we r Date/Time <br /> Relinquished by Signature) ce by (Sign DatefTime <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by DatelTime <br /> Method of Shipment Laboratory Name <br /> fiSpeWE51- <br /> Special <br /> cial Instructions 1 hereby authorize the performance of the above indicated work <br />