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Advanced GeoEnvironmental, Inc. www.advveoenv.com <br />337 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 />F-1395 Del Monte Center, #111, Monterey, California 93940 • Phone (800) 511-9300 Fax (831) 394-5979 <br />Project Name Project M ager, <br />1) �- A L-(--- <br />Client Sam ler (initials&& si�e _. <br />Invoice to: ❑ AGE C Client Lab Project No.: <br />SamplesIID//Location/Description Datiej� Time Matrix Number Notes <br />CHAIN OF CUS'T'ODY RECORD <br />Dater— _Page —�— OfJ- <br />Analysis Required <br />' <br />—5Z5/ <br />Relinquished <br />- <br />Date:Time: <br />70P <br />Laboratory: // <br />�l'4L <br />Courier: <br />Received by: <br />Date: <br />Time: <br />Relinquished by: <br />Date: <br />Time: <br />Received by: <br />Date: <br />Time: <br />Relinquished by: <br />Date: <br />Time: <br />Received by: , �� <br />Date: <br />Time: <br />Requested Tum Around Time (circle 24 hours 8 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@advgeoenv.com ❑ <br />Global ID: <br />