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AdvancedGeo CHAIN OF CUSTODY RECORD Phone: (800) 511 <br /> Fax: (888) 445-87868786 <br /> Environmental <br /> r/� ^^ MAAnalysis Required <br /> �` DATE: i _ +. PAGE "� OF ) <br /> An Employee- Owned Company <br /> Project Name Project Manages <br /> ' ,'t t4 Mkgye <br /> Client Sampler (initials 8 siggature) ,: <br /> Invoice to : AGE ElClient Lab Project No. : <br /> cation/Descri tion Date Time Matrix Number <br /> Notes <br /> Sample ID/Lo p I � <br /> r ► l� 5 (� 1( � 1:+ <br /> it <br /> IP <br /> ! /. <br /> l � <br /> Relinquished by: Date: -�me: Laboratory: <br /> Courier. Received by: Date: erre: <br /> [ t i 4Lk ' <br /> Relinquished by: Date: Time: Received by: i Date: f Time.: <br /> i� <br /> Relinquished by: Date: ' Time: Received by. Date Tlrne. <br /> Requested Tum Around Time (circle) : 24 hours 48 hours 7 hours 5 flays (standard ) Other: Matrix Codes : A = Air W = Water S = Solid <br /> Special Instructions to lab: �f J I hereby a lhohze the performance of the above indicated work. <br /> Global 10: <br /> GeotrackerEDF to: ❑ geotracker@advgeoenv.com <br /> ❑ <br /> �1 <br />