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Advanced GeoEnviron mental, Inc. www.advgeoenv.cotn CHAIN OF CUSTODY RECORD <br /> 837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118 _�_Date: Page_�_of <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 e Fax(831)394-5979 <br /> Project Name Project Manager 4 <br /> Lot V, tvk F It V'_ <br /> Client Sampler(initials&signatur ) <br /> Uj— <br /> Invoice to. AGE ❑ Client Lab Project No.: <br /> v <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> btsiE � <br /> Relinquishe Dat Time: laboratory: <br /> -�-ILI r�n� rC�• <br /> Courier: Receive tsy: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> I I _4 Q G 1 Z 2: j r v <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 ho s 5 days(standard 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 /> Geotracker EDF to: eotracker@advgeoenv.eom ❑ <br /> Global ID: RC j, <br />