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go <br />Geological Audit Services, Inc. <br />Environmen�a Pro/essiona/s <br />1803 West March Lane, Suite A - Stockton, California - 95207 - (209) 956-0264 <br />CHAIN OF USTODY RECORD <br />Date 11 G Page of —Lry 1 <br />ClientV <br />Project Manager <br />Tests Required <br />Phone Number o� <br />26G 52R 61 <br />am lens: (Signature)Invoice: <br />Pr 'ect Name �/ ` <br />f <br />haJ <br />GeoAudit- <br />,� <br />Client <br />Sample <br />Location <br />Sample Type <br />Number Description <br />Date Time' <br />Water Air Solid ConOf Q <br />ts <br />Notes <br />Comp. Grab. <br />T8�-z, <br />Gpp�x�rn� <br />lacy an c)l tank +48 <br />n•t44 42 <br />cls <br />i�9 <br />G <br />qll-0050 <br />He Iquws ad by:(Signature)/ <br />1 <br />l <br />Receivedignalure <br />K T;ArT <br />Date/Time <br />Recei aSi nalur <br />9 <br />elinquished by: (Signature) <br />----- --- <br />Reca ved by Mobile Laboratory for a analysis: (Signature) C X� J/C.0 �j / `� `� <br />' <br />MBpiaqurs d'by: (Signature) <br />Date/Time <br />/" <br />Dispatched by: (Signature) <br />Date/Time <br />Received for Laboratoryb y' <br />Date/Time <br />Method of Shipment: <br />Laratory Name <br />Special Instructions: <br />I her 0y auttrdrize the performance of <br />the above indicated work. <br />