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Advanced Ge®Envir®)nmental, Inc. www.advaeoenv.com CHAIN OF CUSTODY RECORD <br />837 Shaw Road, Stockton, California 95215 o Phone (209) 467-1006 o Fax (209) 467-1118 Date: Page A- of—� <br />381 Thor Place, Brea, California 92821 o Phone (714) 529-0200 • Fax (714) 529-0203 11-05) <br />® 2318 Fourth Street, Santa Rosa, California 95404 o Phone (707) 570-1418 o Fax (707) 570-1461 Analysis Required <br />® 395 Del Monte Center, #111, Monterey, California 93940 o Phone (800) 511-9300 o Fax (831) 394-5979 <br />Project Name ® Project Manager <br />T -�e <br />Client <br />4L.b <br />ler (initials& signature +aroject No.: � <br />Invoice to: AGE O Client <br />CA <br />Sample 1D/Location/Description Date Time Matrix Number Notes \� y <br />Z b '2- 1 t� <br />Relinquished by: Date: Time: Laboratory: <br />O Toa <br />Courier: Received by: Date: Time: <br />Relinquished by: Date: Time: Received by: Date: Time: <br />Relinquished by: Date: Time:Received by: Date: Time: <br />�i <br />Requested Turn Around Time (circle) 24 hou 48 hours 72 ho 5 ye d dyer: Matrix Codes: A = Air W = Water S = Solid <br />Special Instructions to lab: I hereby authorize the performance of the above indicated work <br />M h eKr-t�{e S i c ekd t cool, <br />Global ID: <br />Geotracker EDF to: 0 geotracker@advgeoenv.com <br />