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CHAIN OF CUSTODY RECORD <br /> -�— Geological Audit Services , Inc . <br /> i <br /> EnVironmenw1Prolessiona/s Date rc� Page of <br /> 1600 West March Lane, Suite n - Stockton, California-95207 -(209)956.0264 <br /> moor <br /> Client Pro ect Mana er <br /> LLQ N � C�(S Tests Required <br /> Phone Number <br /> a <br /> Samplers: Si nature Invoice: <br /> /eoAudit T-7 <br /> Project Name Cl pAt,L Nl WTZ-C. <br /> Client ' <br /> Sample Location - ----S�r�eh ------- o No. of i <br /> Date Time Water solid / Notes <br /> Number Description ---- --- Air Conts. i �/ / j <br /> Comp. Grab. <br /> i �J 1 (� �o� tirnf6� _ , %l��r� ;�) ;�. --- ----- -- X_ i X 9V 09/ <br /> D S, <br /> Ilu quis a y: Si na u ef <br /> CWCA 14TDate/Time <br /> V/ 9 <br /> utshed ure) Received by: (Si ature) , D te/Ti e <br /> - <br /> alinquished by: (Signature) Received by Mobile Laboratory for lield analysis: (Signature) Date/Time <br /> Dispatched by: (Signature) Date/Time Received for Laboratory by: Date/Time <br /> Method of Shipman Laboratory Name <br /> Special Instructions: I hereby luthorizo the performance of the above indicated work. <br />