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Advanced GeoEnvironmental, Inc. www.advgeoenv.com CHAIN OF CUSTODY RECORD <br />MV7 Shaw Road, Stockton, California 95215 • Phone (209) 467-1006 • Fax (209) 467-1118 ✓]J Date: T f? 6 Page ( Of <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, #1 11, Monterey, California 93940 • Phone (800) 511-9300 • Fax (831) 394-5979 <br />Project NameProject Manager f v <br />i <br />Client J ( j� _ \ Sampler (initials & signature) <br />V �11zy - Y'1� W fv(— <br />Invoice to: AGE ❑ Client Lab Project No.: �J � (' P r <br />Sample ID/Location/Description Date Time Matrix Number Notes <br />213, <br />3! 1 <br />X <br />-fr2 <br />3: <br />3: q*Z) <br />Ll <br />Relinquished. by <br />(i`J <br />Date: <br />Time <br />Laboratory:^ /�{�'Jj� <br />t[� <br />Courier: <br />Received by.-,' <br />z� <br />Date;// <br />OfVXORV <br />Time: <br />Relinquished by: <br />Date: <br />Time: <br />Received by: <br />Date: <br />Time: <br />Relinquished by: <br />Date: <br />Time: <br />Received by: <br />Date: <br />Time: <br />Requested Turn Around Time (circle): 24 hours 48 hours 72 hours da (standard) Other: <br />Matrix Codes: A = Air W = Water S = Solid <br />Special Instructions to lab:sy,' p /P Jyc <br />l hereby authorize the performance of the above indicated work. <br />N <br />C <br />411r@ <br />Global ID: <br />Gwtracker EDF to: 0 geou dvgeoenv.com El <br />c'" <br />