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g Advanced GeoEnvironmental, Inc. www.advgeoenv.com GAIN OF CUSTODY RECORD <br /> 837 Shaw Road,Stockton,California 95215 a Phone(209)467-1006 a Fax(209)467-1118 Zt -� <br /> Date: 1� �G ) Page of <br /> 381 Thor Place,Brea,California 92821 a Phone(714)529-0200 a Fax(714)529-0203 <br /> ❑23'18 Fourth Street,Santa Rosa,California 95404 a Phone(707)570-1498 o Fax(707)570-1461 Analysis Required <br /> ❑395 Del Monte Center,#111,Monterey,California 93940 a Phone(800)511-9300 a Fax(831)394-5979 <br /> ❑ 1 <br /> Project Name Project Manage / <br /> Cheat Sampler(initials&signal <br /> Invoice to: AGE 0 Client <br /> Lab Project No.: <br /> SampleID/Location/Description Date Time Matrix Number Notes • <br /> 30 <br /> 1 (�1 Cl - 0 <br /> \A1 xx <br /> iRclinquished by: Date: Time: Laboratory: <br /> CgttrieE: `• Received b <br /> a Y Date: Time: <br /> Relinquished by: l/ Date: Time: Received by: Date: Time: <br /> t <br /> Relinquished by: Date: Time: Received by: Date: <br /> Time: <br /> Requested Tun Around Time(circle): 24 hours 48 hours 72 hou 5 days(sta d"d) Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special instructions to lab: 1 hereby authorize the performance of the above indicated work. <br /> t <br /> Geo'tacker EDF to:CI geotracker@advgeoenv.com 0 Global ID: <br />