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Advanced Geoftvironmental, Inc. www.advgeoenv.com CHAIN OF CUSTODY RECORD <br /> X837 Shaw Road,Stockton,California 95215 •Phone(209)467-1006 ®Fax(209)467-1 l 18 12...04)C3 Date: 1 2 GPage-of3 - <br /> _ 381 Thor Place,Brea,California 92821 •Phone(714)529-0200+Fax(714)529-0203 <br /> ' ®2318 Fourth Street,Santa Rosa,California 95404 ®Phone(707)570-1418 •Fax(707)570-1461 Analysis Required <br /> ®395 Del Monte Center,#111,Monterey,California 93940 •Phone(800)511-9300 ®Fax(831)394-5979 <br /> Project Name Project Manager Q <br /> -P <br /> Client Sampler(initials&signature) <br /> Invoice to: 11 AGE 11 Client Lab Project No.: <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> '21 S <br /> 2.JA s , x <br /> 2;Jiib in) <br /> Relinquished /by; Date: � Time-. y <br /> Laborator <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 /> rcic UC2 12-5-- lq 92Zd, <br /> Requested Tum Around Time(circle): 24 hours 48 hours 72 hours 5 ays tandard) Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: 1 herreb(y�authorize the performance of the above indicated work. <br /> Geotracker EDF to: <br /> 0 geotrack nv.com 0 Global ID: <br />