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{,Advanced GeoEnvironmental, Inc. www.advgeoenv.com CHAIN OF CUSTODY RECORD <br /> na <br /> 837 Shaw Road,Stocktnrt Calif rain 95?1S • Phone(2D9)467-1006 • Fax(2Q9)dh7-111R ( )-_ I ! 121— <br /> Date: I i t l I I rage - of t <br /> 381 Thor Place,Brea,California 92821 a Phone(714)529-0200 a Fax(714)529-02032318 Fourth Street,Santa Rosa,California 95404 a Phone(707)570.1418 a Fax(707)570-1461 Analysis Required <br /> ❑ 395 Del Monte Center,#111,Monterey,California 93940 a Phone(800)511-9300 a Fax(831)394-5979 <br /> Project Name Pro' cl Manager N <br /> Client '4 Sampler(initials&signature) ! <br /> D. V <br /> Invoice to: AGE 11 Client Lab Project No.: <br /> PI Z. <br /> Sample ID/Location/Description Date Time Matrix Number Notes �— <br /> i - a l <br /> -wc�k 1 00 X X <br /> S- 5 H +u <br /> 20 ', X X <br /> g� - 7 11135 X <br /> ILA � <br /> `!sb 1 ,C x <br /> Relin had by: Date: Time: La <br /> ' - I I _ <br /> 11 - 11 1-3()6 <br /> L TC�- <br /> Coatier: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> ..._ <br /> Requested Tum Around Time(circle): 24 fours 48 hours 72 hou 7z <br /> 5 days(standard) er Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: 1 hereby authorize the performance of the above indicated work. <br /> Geotracker EDF to:0 geouacker@advgeoenv.com ❑ Global ID: <br />