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Advanced GeoEnviron mental, Inc. www.advgeoenv.com CHAIN OF CUSTODY RECORD <br /> -_- 837 Shaw Road,Stockton,California 95215 o Phone(209)467-1006 • Fax(209)467-1118 Date: I Q 4 II-3 Page 2 of <br /> _ .. 381 Thor Place,Brea,California 92821 o Phone(714)529-0200 o Fax(714)529-0203 dl—1 i, �3 <br /> "• ❑ 2318 Fourth Street,Santa Rosa,California 95404 o Phone(707)570-1418 o Fax(707)570-1461 Analysis Required <br /> F-1395 Del Monte Center,#111,Monterey,California 93940 o Phone(800)511-9300 o Fax(831)394-5979 <br /> Project Name Project Manager <br /> S1 T6" e-aAl �C ��� 'G t3)1/ e- <br /> Client Sampler <br /> ('itia( Is&signature) i <br /> H�AGE ❑ Client Lab Project No.: •�, <br /> Invoice to: 16^y <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> gic-w % ,3 1 <br /> BI1 ( 2'/y <br /> lz W 2� o6 <br /> jy � ? 1LU <br /> Gies- 210 <br /> 3:= <br /> Relinquished by: ., Date: Time: Laboratory: <br /> Courier: Received by: Date: Time: <br /> Relinquished by: Dale: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: -� Date: Time: <br /> Requested Tum Around Time(circle): 24 hours 48 hours 72 hours days 1st lord) Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: 1 hereby authorize the performance of the above indicated work. <br /> Geo[racker EDFto:❑ g eonackeruuadvgeoenv.com 11 Global ll): <br />