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AdvancedGeo CHAIN OF CUSTODY RECORD Phone: (800) 511-9300 <br /> Fax: (888)445-8786 <br /> An Employee-Owned Company DATE: PAGEF <br /> 01, 7� , Analysis Required <br /> Project Manager: <br /> Vik' 'd r—Pi <br /> Project Name: Email: S �o <br /> v <br /> n G wS .— V a. — C.G i�.L �•-- �0 <br /> Client: r r Sampler. J <br /> AQdress�Locatlatr: <br /> Lab PrcdectNo., t a <br /> Sample ID/Location/Description Date Time Matrix Notes <br /> Ni ,., I 15 C 5ti X X 7c• <br /> l�"- � � . `i�l� �2: Z S i �S c•, sr.- X x x <br /> Y. <br /> 1 <br /> Cr,5 t, 1C 1L <br /> 7 <br /> Relinquished by: Date:R ,s ZTi Z Lab&ald y. <br /> Courier. Y L Received by: Date: 71rne- <br /> L 6XXI) O <br /> Relinquished by: Date: Time: Received by: Date: ime: <br /> Relinquished by: Date: Time: Received by: Date: Time: <br /> Requested Turn Around Time: 24 hours 48 hours 72 hours Other: Matrix Codes: A=Air W=Water S=Solid <br /> Special Instructions to lab Global ID: Authorized Signature: <br />