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vanced 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: '�— )—Page ';� Of� - <br /> _ i� ..• 381 Thor Place,Brea,California 92821 • Phone(714)529-0200• Fax(714)529-0203 <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 /> 12) <br /> Project Name f7 Project Manager <br /> Client Sampley initials&sign ure) <br /> Invoice to: ❑ AGE ❑ Client Lab Project No.: <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> 1 y f <br /> a. �- <br /> Relinquished by: // Date: Time: Laboratory: _ <br /> Courier: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: , Date: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hou 5 days(sta rd) Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: 1 hereb authorize the perlonnance of the above indicated work. <br /> Geotracker EDF to:0 geotracker@advgeoenv.com ❑ Global ID: <br />