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Advanced CHAIN OF CUSTODY RECORD <br />An Employee-Owned Company DATE: PAGE } OF , <br />^^�^� <br />Project Mania er: <br />`` L l <br />Project Ne: Email: <br />J n[ �/ <br />Client: J I1 Sampler: , <br />)h s ) C <br />lAddress/Locatio t Lab Project No.: <br />Sample ID/Location/Description Date Time Matrix # Notes <br />Phone: (800) 511-9300 <br />Fax: (888) 445-8786 <br />Analysis Required <br />Vk <br />r <br />Relinquished b J <br />V <br />Date: <br />Time: <br />Laboratory. <br />tv] r <br />Courier: P \` <br />Received by: <br />Date: <br />Time. <br />Relinquished by: <br />Date: <br />91 <br />12 <br />Time: <br />l�� <br />Received b <br />Date: <br />z <br />Time. <br />Relinquished by. <br />Date: <br />Time: <br />eceived ETy. <br />Date: <br />Time. <br />Requested Turn Around Time: 24 hours 48 hours 72 hours <br />5 days" J Other:_ <br />Matrix Codes: A = Air W = Water S = Solid <br />Special Instructions to lab: <br />Global ID: <br />Authoriz6d Vignalur <br />1,) PaLe 13 of 14 <br />