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® Advanced GeoEnvironmental, Inc. wwwadveeoenvcom <br /> CHAIN OF CUSTODY RECORD <br /> 837 Shaw Road.Stockton,California 95215 a Phone(209)467-1006 • Fax(209)467.11 18 <br /> _ _ •• 381 Thor Place,Brea,Califomia 92821 a Phone(714)529-0200• Fax(714)529-0203 O _0 1 Date:1u--L-/ Page t_of / <br /> 2318 Fourth Street,Santa Rosa,California 95404 •Phone(707)570-1418 a Fax(707)570-1461 <br /> 395 Del Monte Center,#I 11,Monterey, California 93940 •Phone(800)511-9300 •Fax(831)394-5979 Analysis Required <br /> Project NCme ❑ <br /> 4 t / Project Manager <br /> Client I1tn C, V�t.(fx.✓ tt ,, U <br /> Sampler thurtais&signature) e V v <br /> Invoice to: �I AGB El Client Lab Project No.: <br /> V <br /> Sample ID/Locarion/Description Date Time Matrix Number l• <br /> Notes � <br /> Lai( Jyt #/ V <br /> x x x x <br /> Reli <br /> Date: Time M: Laborarmy <br /> Courier IG L'1L 17� L <br /> Received <br /> dbby: <br /> � <br /> !/ l/`�v/V 1 if ` Date: Time: <br /> Relinquished by: I <br /> Date: Time: Received by: <br /> Date: Time: <br /> Relinquished by: Date: Time: Received by: <br /> Date: Time: <br /> Requested Tum Around Time(circle): 24 hours 48 hours 72 h 5 days(standard her: _ <br /> Special Instructions to lab Matrix Codes: A=Air w=water S=Solid <br /> 1 her authorize the performance of the above indicated work. <br /> cker EDF eotracker@advgeoenv.com 0 Gbhal ID: <br />