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Advanced GeoEnvironmental, Inc. www.advi4eoenv.com CHAIN OF CUSTODY RECORD <br /> ® 837 Shaw Road,Stockton.California 95215 • Phone(209)467-1006 • Fax(209)467-1118 Date: It-2-5-0y Page--t of� <br /> r.., ❑ 381 Thor Place,Brea,Califomia 92821 a 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,#1 11,Monterey,California 93940 • Phone(800)511-9300 • Fax(831)394-5979 <br /> Project Name ,, p Project Manager <br /> Client — Sampler(initials&signature) <br /> Lab Project No.: t <br /> Invoice to: f Sl AGE ❑ Client <br /> Sample ID/Location/Description Date Time Matrix Number Notes — (- - <br /> 0901 <br /> Cot aC 1 X X <br /> Relinquished by: r Date: Time: Laboratory: <br /> Courier: Received by: Datc: 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 hours 5 da s(standard) ther: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: 1 hereby authorize the performance of the above indicated work. <br /> Global ID: <br /> Geotracker EDF to:K geotracker@advgeoenv.com ❑ <br />