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bin 34 Chain-of Custody Number: <br /> SECOR Chain-of Custody Record <br /> Field Office: 7 LA Additional documents are attached, and are a part of this Record. <br /> Address: 3nn10/ 7 JV Job��- Job Name: <br /> Location: /�3y <br /> Project#9�Z7. j//7 7• k# Analysis Request <br /> Project Manager <br /> Laboratory <br /> Turnaround Time <br /> Sampler's Namemo 5 <br /> o <br /> v is >° 2'q? d =CP a <br /> Sampler's Signature m E E a° 00 p o m a° o 0 <br /> ��• Ep 2 mN 00 >N tl J Ty <br /> 20 om m <br /> SampleU ao ao a Qo off A'o aEiN mo ?m E <br /> x m m ¢ ,� _ y,o a F a` F Comments/ <br /> Instructions z��SI -7SI <br /> S U2d 2 <br /> Special Instructions/Comments: Relinquis by: <br /> Received by: <br /> Sample Recei t <br /> Sig 'gn <br /> Print 7�r- Total no. of containers: <br /> an <br /> p Company <br /> Com Print Chain of custody seals: <br /> y <br /> Time-Y_/ate i o 2 Time Date Rec'd in good condition/cold: <br /> Conforms to record: <br /> Relinquished by: Received b <br /> Sign Sign Client: SGG�j� <br /> Print Print Ono <br /> Company Compan Client Contact: 1t1 <br /> -� <br /> Time Date Time Date Client Phone: J Of�G23 <br /> SECOH CUSRiEC Rev.2/99 <br /> Date: / 9 /oZ Page / of <br />