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1 <br />Advanced GeoEnvironmental, Inc. www.adv jeoenv.corn <br />CHAIN OF CUSTODYRECORD <br />837 Shaw Road, Stockton, California 95215 • Phone (209) 467-1006 a Fax (209) 467-1118 n <br />1STODY <br />Date: -(1 Y i Page of� <br />381 Thor Place, Brea, California 92821 • Phone 529-0200 Fax 529-0203 V5 <br />(714) • (714) <br />' <br />❑ 2318 Fourth Street, Santa Rosa, California 95404 • Phone (707) 570-1418 • Fax (707) 570-1461 <br />Analysis Required <br />395 Del Monte Center, #1 i 1, Monterey, California 93940 • Phone (800) 511-9300 • Fax (831) 394-5979 <br />Project Name <br />Tv <br />Project na <br />Client <br />Sampler (initials & signature) <br />Invoice to: AGE <br />❑ Client Lab Project No.: <br />Sample ID/L*cation/Description Date Time Matrix (Member Notes <br />- el- <br />- ��-1 <br />- �l- <br />1'Ti <br />= <br />D <br />IL <br />rnD Zzoo <br />F1 I <br />O <br />RelinquishepLeL <br />Date: <br />Time: <br />Laboratory: <br />�"j <br />courser: <br />Received by: <br />Date: <br />Time: <br />Relinq•uished by: <br />Date: <br />Time: <br />Received by: <br />Date: <br />Time: <br />Relinquished by: <br />Date: <br />Time: <br />Received by: 1 <br />Date <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 tab: <br />I hereby authorize the performance of the above indicated work. <br />•. <br />Gbbal ID: <br />0 (� <br />tracker EDF to: geotracker(jgadvgecenv.com <br />1 <br />