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Advanced GeoEnvironmental, Inc. www.advaeoenv cpm CHAINOF CUSTODY RECORD <br /> 837 Shaw Road,Stockton,California 95215 a Phone(209)467-1006 • Fax(209)467-1118 Date:3���—� L Page / of_l� <br /> •®..,•,• ❑381 Thor Place,Brea,California 92821 a Phone(714)529-0200• Fax(714)529-0203 03 <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 a Fax(831)394-5979 <br /> ❑ -- <br /> Project Name _ Project Manager Vu <br /> Client Sampler(fiiit lS&signature) <br /> Lab Project No.: <br /> Invoice to: AGE L1 Client <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> SPi <br /> 2 :3L) / <br /> .2'25 x <br /> Spy-) 2,'35 x <br /> - 2- " 2 "f'5 x <br /> S02-4 2 : i�D X <br /> _ � X <br /> Relinquished by: , Date: Time: Laboratory: <br /> Courier: Received by: <br /> Date: Time: <br /> Relinquished by: Date: Time Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: I _ Date: Time: <br /> Q - 3 <br /> Requested Tum Around Time(circle): 24 hours 48 hours 72 hours (Lays standard) Other: Matriz Cafes: A=Air W=Water 5=Solid <br /> Special Instructions to lab: " I hereby authorize the performance of the above indicated work. <br /> w�Liu- Ltvl �- <br /> Gcorracker EDF OQeotmckcr@advgemnv.com 0 Global lD'. <br />