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Advanced GeoEnvironmental, Inc. WWW.advgeoenv.com CHAINOFCUSTODY RECORD <br /> 1A837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118 ^7 Date: p Page �-of <br /> - !S <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(83 1)394-5979 <br /> Project Name /�6MProject Manager <br /> C..7C-v-,�, if <br /> Client Sampler(initials&signature <br /> ff <br /> Invoice to: AGE ❑ Client Lab Project No.: i \ _ + <br /> Sample 1D/Location/Description Date Time Matrix Number Notes <br /> �t' C Sv <br /> AA <br /> W 4 9 —(no 6.F6 S o loo r, S � k <br /> Relinquished by: Date: Time: Laboratory: {; <br /> Courier: 1^ Received by: Date: Time; <br /> Y f <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: n/ Date: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours T'hours ys( a dard) 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 /> d4&A44— <br /> Geotracker EDF to: Elgeotrackerruadveeoenv.com ❑ Global ID: . <br />