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Advanced GeoEnvironmental, Inc. WWW.advgeoenv.com CHAIN OF CUSTODY RECORD <br /> ® 837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118 Date: —mss- �� Page_;_of-112 <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 Analysis Required <br /> 395 Del Monte Center,#111,Monterey,California 93940 • Phone(800)511-9300 •Fax(831)394-5979 <br /> ❑ d <br /> Z.� <br /> Proect Name Project Manager <br /> Client Sampler(initials& iat r <br /> t <br /> Invoice to: r AGE El Client Lab Project No.: t, <br /> f 11 <br /> Sample ID/Location/Description Date Time Matrix Number notes <br /> 0 7- <br /> Relinquished by: Date: Time: <br /> Time: Laboratory: I( i <br /> It <br /> Courier, <br /> /�t\ Received by: Date: Time: <br /> V ,J'`t� <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date:IF y ry Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hourss(standar Other: / Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: I hereby authorize the performance of the above indicated work. <br /> Global ID: <br /> Geotracker EDF to: eotracker@advgeoenv.com ❑ <br />