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Advanced GeoEnvironmental, Inc. www.advgeoenv.com CHAIN <br /> /y OF CUSTODY RECORD <br /> 37 Shaw Road,Stockton,California 95215 a Phone(209)467-1006 •Fax(209)467-1118 Date: �/�Page—toi�. <br /> _ ❑ 381 Thor Place,Brea,California 92821 • Phone(714)529-0200 a Fax(714)529-0203 <br /> ❑2318 Fourth Street,Santa Rosa,California 95404 • Phone(707)570-1418 • Fax(707)570-1461 Analysis Required <br /> F-1395 Del Monte Center,#1 11,Monterey,California 93940 •Phone(800)511-9300 a Fax(831)394-5979 <br /> Project Name Project Manager a <br /> Client Sample (initials&signature) <br /> 11 t 1 <br /> Invoice to: X.AGE ❑ Client Lab Projekt No.: <br /> D <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> - l0 1o0o S 1 <br /> -Zfl tato S <br /> 2 —lo �0 30 S <br /> o3 <br /> 3 4 1 Ir LorwI <br /> 3-W 3 (100 s 1 <br /> ID ( l S 1 <br /> Relinquished by Date: Time: Laboratory: <br /> Courier: Received by: Date: Time: <br /> V ' l <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Requested Tum Around Time(circle): 24 hours 48 hours 72 hours 5 days(standard) Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: MW e �/jF l 1 1 .Ir( ! r� 1, R,„ ,/ Ov1 /t I he ihorize a performance of the above indicated work. <br /> 1 C.v�\�/�� J Global I�D(/ (i(,�'t Y N 'V � ' I <br /> Geotraeker EDF to: ❑ geouacker@advgeoenv.com ❑ <br />