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Advanced GeoEnvironmental, Inc. www.advjzeoenv.com CHAIN OF CUSTODY RECORD <br /> 837 Shaw Road,Stockton,Califomia 95215 • Phone(209)467-1006 • Fax(209)467-1118 ��^^ Date: '-,2-Page—(-of—L <br /> ii 381 Thor Place,Brea,California 92821 • Phone(714)529-0200•Fax(714)529-0203 ub — Q G P <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 • Fax(831)394-5979 <br /> Project Name 44 Project Manager <br /> Client Sampler(initials&signature) Qa <br /> Invoice to: AGE ❑ Client Lab Project No.: <br /> R <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> 1,17 <br /> w <br /> �V-t4 F3idZl l z— _ <br /> �` o-kb D, 27C <br /> Relinquished b : Date: r7 Time: laboratory: <br /> Courier: Received by: Dale: Time: <br /> ��.. <br /> Relinquish by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: Received by: %', / Date: Time: <br /> jf. ✓ qq <br /> Requested Tum Around Time(circle): 24 hours 48 hours 72 ho s 5 days(standard 0 1her _ Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab: I hereby authorize the performance of the above indicated work. <br /> Geotracker EDF to: eotracker@advgeocnv.com ❑ Global ID: <br />