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Advanced GeoEnvironmental, Inc. www.adv-Qoenv.com CHAIN OF CUSTODY RECORD <br /> 5Q 837 Shaw Rnad,Swckton,Cal iIbmia 95215 •Phone(209)461-1006 * Fax(209)467-1118 Date: 41 I CA 'L!3 t Page_L off cA <br /> 381 Thor Place,Brea,California 92821 e Phone(714)529-0200*Fax(714)529-0203 <br /> 2318 Fourth Street,Santa Rosa,California 95404 •Phone(707)570-1418 •Fax(707)570-1461C Analysis Required <br /> 395 Del Monte Center,#111,Monterey,California 93940 •Phone(800)511-9300 *Fax(831)394-5979 <br /> L <br /> Project Name Project Manager <br /> Client Sampler(initials&signature) <br /> ~C —/ � <br /> Invoice to: AGE ❑ Client Lab Project No.: Z <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> ......._...___. <br /> 0- 1 — )9 2 Zi< S' 1 ® f inej <br /> �3 � �t to �• 3-3 <br /> 1 rt z <br /> 3 -2 ,� <br /> J. 5 —1 i .11 1 <br /> Relinquished by: Date: Time: Laboratory: <br /> Courier: Received by: Date: f Time: <br /> Cl i ; t - a� &� 30 <br /> Relinquished by: Date: Time: 1 Received by: Date:I Time: <br /> Relinquished by: Date: Time: Received by: Dace: Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hours 5 days(standard) che,. Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: 1 hereby authorize the performance of the above indicated work. <br /> Geotracker EDF to:❑ geotracker@advgeoenv.com ❑ Global ID: /M� <br />