Laserfiche WebLink
Advanced GeoEnviron mental, Inc. www.advgeoenv.com <br />837 Shaw Road, Stockton, California 95215 • Phone (209) 467-1006 • Fax (209) 467-1118 <br />381 Thor Place, Brea, California 92821 • Phone (714) 529-0200 + Fax (714) 529-0203 ' <br />:; ❑ 2318 Fourth Street, Santa Rosa, California 95404 • Phone (707) 570-1418 • Fax (707) 570-1461 <br />❑ 395 Del Monte Center, #I 11, Monterey, California 93940 • Phone (800) 511-9300 « Fax (831) 394-5979 <br />Project Name y Project rna r <br />L lilt, <br />Client Sampler (initials & signature) _ <br />Lab Project No.: <br />Invoice to: AGE CI Client <br />Sample ID/Location/Description Date Time Matrix Number Notes <br />CHAIN OF CUSTODY RECORD <br />Date: ���-� Page - of <br />Analysis Required <br />' <br />LI-1 <br />Relinquish e y: _ <br />_ _ <br />Date: ppb p <br />Time: <br />Laboratory: <br />Courier: <br />Received by: <br />Date: <br />Time: <br />Relinquished by: <br />• <br />Date: <br />Time: <br />Received by: <br />Date: <br />Time: <br />Relinquished by: <br />Dale: <br />Time: <br />Received hy:' 1 <br />J <br />Date: <br />�- <br />Time: <br />Requested Tum Around Time (circle : 24 hours 4 hours 72 hours 5 days (standard) Other:_ / <br />Matrix Codes: A = Air W = Water S = Solid <br />Special Instructions to lab: <br />I hereby authorize the performance of the above indicated work. <br />Geotracker EDF to: ❑ geotracker(aadvgeoenv.com 11 <br />Global ID: <br />