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Advanced GeoEnvironmental, Inc. www.advizeoenv.com <br />E!r837 Shaw Road, Stockton, California 95215 • Phone (209) 467-1006 • Fax (209) 467-1118 <br />CHAIN OF CUSTODY RECORD <br />Date: W& OT Page / of, <br />381 Thor Place, Brea, California 92821 • Phone (714) 529-0200 e Fax (714) 529-0203 <br />2318 Fourth Street, Santa Rosa, California 95404 • Phone (707) 570-1418 • Fax (707) 570-1461 <br />Analysis Required <br />❑ 395 Del Monte Center, #111, Monterey, California 93940 • Phone (800) 511-9300 o Fax (831) 394-5979 <br />Project Name Project Man ger <br />-715-7-a la1% - t / <br />Client Sampler (initials & signator <br />44C, <br />eWhAAk011 <br />Invoice to: RAGE <br />13 Client Lab Project No.: <br />Sample ID/Location/Description <br />Date Time Matrix Number Notes <br />x.-11 <br />i2� ia� <br />'KI <br />I <br />—c7 <br />:3c> <br />I2-iev0 <br />Relinquished by: <br />Date: Time: Laboratory: <br />Courier: <br />Received by: <br />Date: <br />Time: <br />Relinquished by: <br />Date: <br />Time: Received by: <br />Date: <br />Time: <br />Relinquished by: <br />Date: Time: Received by: f <br />Date: Time: <br />)) <br />Requested Turn Around Time (circle): 24 hours 48 hours 72 hours(5 day standard) Other: �' <br />Matrix Codes: A =Air W =Water S =Solid <br />Special Instructions to lab: <br />i hereby authorize the performance of the above indicated work. <br />W <br />Geotracker EDF to: 0 geotracker@advgeoenv.com 0 <br />Global ID: <br />