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CHAIN OF CUSTODY RECORD <br /> 4C T�* <br /> Geological Audit Services , Inc Date22 qs� gageQ <br /> _�— Enviror�men1a/Professionals <br /> MEL <br /> 1603 West March Lane Suite A Stockton Cahlornta 95207 (209)956 0264 <br /> r <br /> ClientProject Manager <br /> Tests Required <br /> C ` , <br /> Phone Number <br /> Sam lers (Signature) ` Invoice <br /> Project Name ' / �, GeoAudit <br /> Pro <br /> 1 ,' Clientf <br /> ample Type <br /> tif. i <br /> Sample Location Water No of <br /> Date Time Solid ,(� �,lL , Notes <br /> Number Description Comp crab Air Conts 1�' <br /> ' i <br /> ZZ3 911' <br /> i <br /> 68 " l0IY4 e617 Pel 2 Z0s /1(9lca- X t <br /> �ieen 2;z4,q111,04- LT <br /> X J x <br /> e FmVsh e d b y tgnalure ace gna ure r ate/Ttme <br /> ql� b44 2 <br /> l <br /> Rel q a gnat R c ve b a e(Ttme <br /> r <br /> Re n s y [gnat eeived by Mobile Laboratory for lield analysts (Signature) bate/Time <br /> Dispatched by (Signature) Date/Time Received for Laboratory by Date/Time <br /> Method o! Shipment Labo !or <br /> SpecialInstructions /) I her auIhoI erformance of the above tncitcated work <br />