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® Advanced GeoEnvironmental, Inc. w .adv¢eoenv.com CHAIN OF CUSTODY RECORD <br /> 837 Shaw Road,Stockton,California 95215 a Phone(209)467-1006 •Fax(209)467-1119 Date: Q—L(—I` Page_L of_�_ <br /> 381 Thor Place,Brea,California 92821 a Phone(714)529-0200•Fax(714)529-0203 V-%_O '``-� <br /> :: ❑ 2318 Fourth Street,Santa Rosa,California 95404 •Phone(707)570-1418 a Fax(707)570-1461 Analysis Required <br /> ® F-1 395 Del Monte Center,#111,Monterey,California 93940 •Phone(800)511-9300 a Fax(831)394-5979 <br /> Project Name Project Manager <br /> i <br /> Client Sam (milials&signature) LJ <br /> tNo.; ( . <br /> Invoice to: AGC ❑ Client Lob 1�^ <br /> Sample M/Locanon/Descrlpnon Date Time Matrix Number Notes <br /> C<A ALL Y�j <br /> J•-�i g D •2�- <br /> -- fW 13 well VW-5B <br /> Relinquished by: Date' Time: Laboratory: <br /> �- <br /> Courier'. Received by: Date: Time: <br /> P� <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Requested Tun Around Time(circle): 24 flours 48 hours 72 hour 5 days(standard) her: / Matrix Codes: A=Air W—Water 5=Solid <br /> Special Instructions to lab: I hereby authorize the performance of the above indicated work <br /> Geotrackerf_DFi. eonaeker@advgeoenv_com ❑ GlobalID: <br />