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Advanced GeuEnvironmental, Inc. www.advpeoenv.com <br />837 Shaw Road, Stockton, California 95215 ® Phone (209) 467-1006 ® Fax (209) 467-1118 <br />381 Thor Place, Brea, California 92821 ® Phone (714) 529-0200 • Fax (714) 529-0203 (� <br />CHAIN OF CUSTODY RECORD <br />Date:m/_Page of� <br />2318 Fourth Street, Santa Rosa, California 95404 a Phone (707) 570.1418 *Fax (707)570-1461 <br />Analysis Required <br />® 395 Del Monte Center, #111, Monterey, California 93940 ® Phone (800) 511-9300 a Fax (831) 394-5979 <br />Project Name � � Project Manager <br />AL+ 6e, Le <br />Client Sampler (initials & signature) <br />Lab Project No.: <br />Invoice to: AGE ❑ Client <br />l <br />� <br />Sample ID/Location/Description Date Time Matrix Number Notes <br />Relinquished bb Date: Time: laboratory: <br />L r pD$ t 7UD <br />Courier: Received by: <br />Dr -4f -A -C <br />Date: <br />Time: <br />Relinquished by: <br />Date: <br />Time: Received by: <br />Date: <br />Time: <br />Relinquished by: Date: Time: Received by: <br />Date: Time: <br />t <br />-12_--`6 9: <br />Requested Turn Around Time (circle): 24 hours 48 haus 72 hours 5 days (standard) er: <br />Matrix Codes: A = Air W = Water S = Solid <br />Special Instructions to lab: <br />E;,V, /`c5ul?�S �© 1# M 14L5orib g�j Ef,<D�towt INie�t- arr-r!- L� ario� <br />I hereby authorize the performance of the above indicated work. <br />Global ID: <br />Geotracker EDF to: 11geotracker@advgeoenv.cotn 11 <br />