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/ / / V .-- / / <br />Advanced-- <br />Environmental <br />'\'`` <br />An Emplu ee-Owned Cormparl), <br />Project Name <br />Client <br />Invoice to: AGE ❑ Client <br />Sample ID/Location/Description Date Time <br />CHAIN OF CUSTODY RECORD <br />DATE: I() Il: PAGE OF� <br />Project Manageq+ <br />11 A <br />, r! V n1 <br />Sampler (fnitials 8 signature) <br />Lab Project No.: <br />Matrix Number Notes <br />Phone: (800) 511-9300 <br />Fax: (888) 445-8786 <br />Analysis Required <br />WJ <br />Relinquished by: / <br />Date: <br />i c <br />� <br />�, <br />Time: \ <br />i✓ <1�c, <br />Laboratory: <br />1� � <br />Courier: <br />ILS" <br />Received b : <br />Date: <br />- I <br />Time: <br />I i.>rb <br />Relinquished by: <br />Date: <br />Time: <br />R ceiv d by: n <br />Dale: <br />Time: <br />Relinquished by: <br />Date: <br />Time: <br />ece ved by: <br />Date: <br />Time: <br />Requested Turn Around Time (circle): 24 hours 48 hours 72 ho 5 days (standard) r: <br />Matrix Codes: A = Air W = Water S = Solid <br />Special Instructions to lab: <br />I hereby authorize <br />the performance of the above indicated <br />i <br />work. <br />Geolracker EDF to: ❑ geotracker@advgeoenv.com ❑ <br />Global ID: <br />Pa-- -t <br />