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AdvancedGeo CHAIN OF CUSTODY RECORD Phone: (800) 519-g300 <br /> Environmental Fax: (888) 445=8786 <br /> SIN�� Analysis Required <br /> `JJ DATE: l i PAGE ) OF ') <br /> IVa <br /> An Employee-Owned Company <br /> Project Name ti Project Maler <br /> Ciient Sampl^er (initials & silple ure) <br /> Invoice to: AGE ❑ Client Lab Project No.: <br /> Sample IDILocation/Description Dale Time Matrix Number Notes <br /> .: f r � 5 d LcJ <br /> I <br /> I, <br /> q <br /> I► , <br /> Relinquished by: Date: Time: Laboratory: <br /> Courier. Received by ;' _ Date: Time: <br /> Ll r \III % <br /> Relinquished by: Date: Time: Received by: �I Date: Tim,e%' <br /> i <br /> Relinquished by: Date : Time: Received by. Date Irie_ <br /> Requested Tum Around Time (circle) : 24 hours 48 hours/ 7 hours 5ays (standard ) Other: Matrix Codes : A = Air W = Water S = Solid <br /> Special Instructions to lab: j I hereby a horize the performance of the above indicated work. <br /> II ri I <br /> Geotracker EDF to: ❑ geotracker@advgeoenv.com ❑ Global ID : / r <br />