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AdvancedGeo CHAIN OF CUSTODY RECORD Phone: (800) 511-9300 <br /> Environmental Fax: (888) 445-8786 <br /> XY <br /> Analysis Required <br /> DATE: PAGE OF <br /> An Employee-Owned Company <br /> Project Name Project Manage <br /> Client Samp r(initials&sign <br /> Lab Project No.: <br /> Invoice to: AGE EJ Client U� <br /> Sample ID/Location/Description Date Time Matrix Number Notes <br /> Khe— WeiRelinquished by: ` Date: Time: Laboratory: <br /> Courier: / Re iv d by: Date: Time: <br /> !, -7// / / /� <br /> Relinquished by: Date: Time: Rece ed b Date: Time: <br /> Relinquished by: Da e: Time: Received by: Date: Time: <br /> 7. <br /> Requested Turn Around Time(circle): 24 hours 48 hours 72 hours days tandard) Other: <br /> 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: Elgeotracker@advgeoenv.com ❑ Global ID: �� l.lily <br />