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Advanced GeoEnvironmental, Inc. www.advgeoenv.com CHAIN OF CUSTODY RECORD <br /> O;T837 Shaw Road,Stockton,California 95215 a Phone(209)467-1006 • Fax(209)467-1118 <br /> i Date: Page of <br /> 381 Thor Place,Brea,California 42821 o Phone(714)529-0200• Fax(714)529-0203 ( ,} I <br /> "' ❑ 2318 Fourth Street,Santa Rosa,California 95404 o Phone(707)570-1418 a Fax(707)570-1461 <br /> Analysis Required <br /> ❑ 395 Del Monte Center,#111,Monterey,California 93940 • Phone(800)511-9300 a Fax(831)394-5979 <br /> Project Name,—;— � f �/} Project Manager f 1} J f <br /> 11L s".144j, <br /> Client Sampler(initials_&signs ure)f <br /> Ny <br /> Invoice to: �( �AGE ❑ Client Lab Project No.: <br /> Sample ID/Location/Description Date Time Matrix Number Notes " <br /> i V <br /> v. ccfll <br /> Relinquished by.-/' r Date: Time: Laboratory: <br /> Courier: Received by: <br /> Date: Time: <br /> 14- <br /> Relinquished by: ° Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: / Date: <br /> Time: <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hour 5 days(standard) Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: <br /> ;, .. jf I hereby authorize the performance of the above indicated work, <br /> cl,-t,\— kc,'V <br /> Global 1D: <br /> Geotracker EDF to: geotracker@advgeoenv.com 0 / <br />