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dvanced GeoEnvironmental, Inc. www.adveeoenv.com CHAIN OF CUSTODY RECORD <br /> 837 Shaw Road,Stockton,California 95215 •Phone(209)467-1006 •Fax(209)467-1118 `` Date: 16 -�0 1_3 Page`of �. <br /> ___ ��,:., ❑381 Thor Place,Brea,California 92821 •Phone(714)529-0200•Fax(714)529-0203 { I- '0 d (:j <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 /> Project Name Project Manag <br /> Client i Sampler(initials&signatu e <br /> Lab Project No.: <br /> Invoice to: AGE © client <br /> Sample ID/LocationlDescriptian Date Time Matrix Number Notes <br /> - 05V <br /> Relinquished b : Date: Time: Laboratory: <br /> _�� <br /> Courier. Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: <br /> Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Timc: <br /> { ( )a <br /> 72 hours days(standard Other: Matrix.Codes: A=Air W=Water S=Solid <br /> Requested Turn Around Time{circle}: 24 hours 48 hours <br /> I hereby authorize the performance of the above indicated work. <br /> Special Instructions to lab: <br /> Global ID: <br /> LCI .track., :❑ geotracker@advgeoenv.com 0 <br />