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Advanced GeoEnvironmental, Inc. www.advgeoenv.com CHAIN OF CUSTODY RECORD <br /> 0 837 Shaw Road,Stockton,California 95215 • Phone(209)467-1006 •Fax(209)467-1118 )hq; I i <br /> Date: Page_of <br /> .• ❑ 381 Thor Place,Brea,California 92821 • Phone(714)529-0200• Fax(714)529-0203 0� -I 1 <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 r Project Manager <br /> ��11 � <br /> Client V Sampler(initials&signature) <br /> Invoice to: �J AGE El Client <br /> Lab Project No.: - + <br /> Sample ID/Location/Description Date Time Matrix Number Notes ' <br /> It I ) 1 ' 2v c; <br /> 1' 2t -LI 1 11, 2_Fj <br /> a,72- h Ili fv <br /> 4_1 i i <br /> Relinquished by: Date: Time: laboratory: <br /> 1 Ltd 'ri 13 i�.3'� �/ �i l� EJ%,l✓ <br /> Courier: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by ri Date: Time: <br /> j <br /> Y <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hours days andard) Other Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: I hereby authorize the performance of the above indicated work. <br /> nfv -, T <br /> Global ID: l�)�Q �.Lt��/` <br /> Geonacker EDP lo:0 geovacker@advgecenv.com ❑ <br /> If2� <br />