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Advanced GeoEnvironmental, Inc. wxxx�w&-eoenv.coln CHAIN OF CUSTODY RECORD <br /> 937 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 • Pas(209)467-1119 Date: 24.14 Page_L of- <br /> i. .. ❑ 391 Thor Place,[arca,CaIilornia 92921 * p here(714)529-0200• Fax(714)529-0203 07 -is ? <br /> ? - ❑ 2319 Fourth Street.Santa Roza.Calili,n,in 95404 . Phone(707)570-1413 * Fix(707)570-1461 Analysis Required <br /> 395 Del Monte Center,#1 11,Monterey,CaIitornia 93940 • Phone(900)511-9300 • Fax(83 1)394-5979 <br /> Project Nun,s�. Project Manager x y <br /> I r j QXcu o TYtuk� �'"i"1"�6� , D6 CA� N <br /> C'lienl Sampler&inilrial,{�&sign,,Iu�rJ'e) <br /> Lah project No.: ' �1 <br /> Invoice ln: 71, AGC ❑ Client <br /> Sample lD/Locatinn/Description (late Time Matrix Number Votes {-" �•'� <br /> 5kir 1-13-01 tLkto <br /> -15 15(5 5 1 ( n <br /> 13-I ` 19 5-`6'1- 14)-04 1515 Kx <br /> 01 2D .5 1 � )� <br /> 0113q 5 1 <br /> Relinquished by / r / X7 <br /> s-2.5-oq 1100 Lahnr:uory: C t r_ / <br /> {J%_ l�t� <br /> Currier: Received hy: Dale: Time: <br /> D NTRAt <br /> Relinquished be: Date: Tiara: Reemed by.: We Time: <br /> Relinquished by: Date: 'time: Itcccircd hy: ^�''� `� Date: Time: <br /> Requested rum Around rime(circle): 24 hours 49 huors T_hours 5 days)standard) ( her: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: '�� I hereby authorize the performance olthe above indicated work. <br /> _L Gluteal 1D: ✓�J" � "iQ <br /> Gcolrucker EDF to:❑ geotrackcr(rnadvgenenv.com ❑ NDr � U1 ll" j&'/1 <br />