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i <br /> (10CHAIN OF CUSTOD CORD <br /> Geolo ical Audit Services Inc. -A7- <br /> En��nmenta/Pro&FS10nals } Date <br /> Page of <br /> r. <br /> 1803 West March Lane Suite A Stockton California-45207 (209)956 0264 <br /> 1! <br /> Client Ro 1 C0 V1 W,a Project Manager <br /> Tests Required <br /> Phone Number <br /> Samplers (Signature) / , Invoice <br /> �} � <br /> Project Name C p L,1w, ci Y fir^o P Q r^�� / - n '�i1 ��-�,l fL �vt, :° / / GeoAudnClient <br /> Sample Location Sample Type No of �r / <br /> Date Time Water Solid Q Notes <br /> Number Description Comp Grab Air Conts <br /> I�`T IA/ <br /> W,51 S UiA r1! � 7 ��e)�� � 17 <br />✓T S - 1 '5- 5coo 5,d,1,,o 1� ,-t q, I ) 7- �c <br />/T IVy iq Nc,-,k 5,4,w#1i l 1rft-4-,wft 17 317 f <br />,T Q -- 13 TmiA p, I biro" 13 f to deo 17, L!U <br /> i <br /> einquis e y (Signature) FO-cei by ignatur OatslTime <br /> r7 `G- 57�Kt1Qr d 7fl q� <br /> Relinquished by (Signature) Received by (Signature) Date/Time �1 <br /> Relinquished by (Signature) Received by Mobile Laboratory for field analysis (Signature) Date/Time <br /> Dispatched b (Signature) oate/Time Received for Laboratory b <br /> p Y ( 4 ) rY Y Datefr-ime <br /> Method of Shipment Labo raliory Name <br /> Special Instructions I hereby authorize the performance of the above indicated work <br /> I <br />