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Advanced GeoEnvironmental, Inc. www.advgeoenv.cotn CHAIN OF CUSTODY RECORD <br /> X837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Fax(209)467-1118t� <br /> yy Date: �I i<' Page l of-L <br /> 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,4111, Monterey,California 93940 • Phone(800)511-9300 • Fax(831)394-5979 <br /> ❑ g <br /> Project Name Project Manager �, i TT- A- <br /> ti.0 <br /> Client Sampler(initials&signature _ <br /> VL <br /> t J v <br /> y <br /> Invoice to: ' AGE ❑ Lab Project No.: <br /> Client (`. <br /> Sample ID/Location/DescriptionDate Time Matrix Number Notes �. <br /> 14 <br /> Relinquished by - Date: Time: Laboratory: - <br /> 11 <br /> Courier:('? Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: t / �� Date: Time: <br /> Requested'I' rn Around Time(circle): 14 hours d8 hows 72 hour 5 days(standard they: V 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 EDT to: t geonacker@advgcoenv.com ❑ t <br />