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dw <br /> vanced GeoEnvironmenta9, Inc. ww advgeoenv.com CHAIN OF CUSTODY RECORD <br /> 37 Shaw Road,Stockton,California 95215 •Phone(209)467-1006 • Fax(209)467-1118 Date: C)" Ll 'Mage L 6fJ <br /> �,.., �'�f1381 Thor Place,Brea,California 92821 •Phone(714)529-0200 a Fax(714)529-0203 1 <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 a Fax(831)394.5979 <br /> Project Name ❑ r Project Manager <br /> Client Sampler(initials&signatur - <br /> 8141A A., <br /> Invoice to: dr AGE ❑ Client Lab Project No.: <br /> Sample ID/Location/Description Date Time Matrix I Number Notes �- <br /> 1 01 % Un'm 0-11- l'w S <br /> 5otl wu r <br /> RelinquisDate:: Time: Laboratory: <br /> V E L <br /> Courier. Received by: Date: Time: <br /> Di�-+>r�r✓ <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Relinquished by: Date: Time: . Received by: Date: Time: <br /> Requested Tum Around Time(circle): 24 hours 48 hours 72 hours dar Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special instructions to lab: - - -- - - I hereby authorize the performance of theaboveindicated work.. - <br /> Cxmracker EDF to:�geotrackerQadvgeoenv.com D Global ID: l <br />