Laserfiche WebLink
1 A' 11 <br /> AdvancedGeo CHAIN OF CUSTODY RECORD Phone: (800) 591-9300 <br /> Environmental Fax: (888) 445-8786 <br /> Analysis Required <br /> DATE: l L —PAGE_� OF <br /> Ao E/nployee-Ownecl Cnaipciny <br /> Project Name Proje t Manager , <br /> �� A �' J <br /> Client J Sampley�(ini,i Is&si ature + <br /> -v-1. <br /> Invoice to: AGE ❑ Client Lab Project No.: f <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> n - <br /> Relinquished by: l Date: Time: Laboratory: / r <br /> Cf L <br /> Courier: ReceivR Date: Time: <br /> Relinquished by: Date: Time: Received by: / Date: Time: <br /> oz� i �C 1 ' 0 X20 (3: <br /> Relinquished by: Date: Time: Receive y: Date: Time: <br /> i <br /> Requested Turn Around Time(circle). 24 hours 48 hours 72 ours 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 /> C <br /> A Global ID: /� �/ VX <br /> Geotracker EDF to:, geotracker@advgeoenv.com ❑ A- [[ <br /> PaLle 7 of <br />