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<br />_____, 1 <br />Advanced GeoEnvironmental, Inc. ANww.advgeoenv.com CHAIN OF CUSTO RECORD <br />837 Shaw Road, Stockton, California 95215 • Phone (209) 467-1006 • Fax (209) 467-1118 <br />i <br />1 <br />. . Date: / 2- 1 / Page of I <br />,- LII 381 Thor Place, Brea, California 92821 • Phone (714) 529-0200 • Fax (714) 529-0203 / 2 13 4 <br />.::.:::...i.- . 2318 Fourth Street, Santa Rosa, California 95404 • Phone (707) 570-1418 • Fax (707) 570-1461 Analysis Required <br />395 Del Monte Center, #I11, Monterey, California 93940 • Phone (800) 511-9300 • Fax (831) 394-5979 <br />›....,,-...s, <br />Project Name ,47.1 _ 1 <br />14/1 17 0 9r-el ;)-(-21 T) <br />Project Manager <br />DttiA i,e-E._( <br />, <br />i(i /lb e L_Pc; <br />Client / <br />4 <br />J 7)/ <br />(.,iftct°4ef <br />Sampler (inip s & signature) <br />/ _It- \ <br />i <br />-• r <br />t \i, (C--••-•-• <br />---.. <br />4- <br />„-_,_L-.. <br />.tj <br />Invoice to: 1 AGE Cl Client <br />Lab Project No.: ,.'—). -........rs, C''' n I -•,:- g.„.„.,;,..; <br />San ple ID/Location/Description Date Time Matrix Number Notes <br /> <br />1,7-kg'', i 1.--10(4) 4 <br />i g-it..) 6 A ) X- X <br />l'IN Lt - 5 iliql i 1 vi 1 31 0 1.4) 3 <br />Relinquished by: / /Date: // <br />(i tz_i / <br />Time: <br />17116 <br />Laborato • b ry. <br /> <br />/ <br />Courier: j <br />_- <br />Received by: Date: Time: <br />Relinquished by: Date: Time: Received by: Date: Time: <br />Relinquished by: Date: Time: Received by: <br />rr-- <br />Date: .. Time: <br />Requested Turn Around Time (circle): 24 hours 48 hours 72 hours 5(2,s (stancla3) Other: ,Matrix Codes: A = Air W = Water S = Solid <br />Special Instructions to lab: I herebAuth rize the p rf -mance o le above indicated work. <br />• n <br />'./ <br /> <br />Geotracker EDF to: E geotracker@advgeoenv.com O Global ID: