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0 Chain-of Custody Number 9 <br /> SECOR Chain-of Custody Record C, 96 1126 <br /> Additional documents are attached, and are a part of this Record <br /> Field Office )-,tog- <br /> Address 13 i�Ew PAS5 S Job Name S <br /> _Cnncbr CA_ q4V 510 - Location �` ' w C �'`� — <br /> c C, <br /> Analysis Request <br /> f roject # N l-e;VL-0) _Task#Com_ <br /> Project Manager 'TAn_ 'r 12 <br /> Q <br /> Laboratory �?N a _ <br /> to <br /> Turnaround Time a a o eg w <br /> d y io dU <br /> �7 G1 W o o.� �o 0o 0o 9O my �r d m <br /> Sampler's Name ►- o ,. m g p <br /> LN mN 00 N <br /> Sampler's Signaturelaaei6raT z E 9 "� N o Comments/ z <br /> Sam le ID Date Time Matrix z z ^ a Eu Instructions <br /> F 11 !j !l;oo Air <br /> r <br /> Sample Receipt <br /> Special Instructions/Comments Relinquished by S_ _Grdr — b/ Total no of containers z <br /> ` � Sign Sign <br /> �1¢�se dI � to Print C Print Chain of custody seals <br /> Company_ SE�o� _ Compan Recd in good condition/cold <br /> # CConforms to record <br /> s►kl`a.�,¢„�b a F�o2 Time 3: Date f t Time ` Date KI <br /> -Tb a D Relmshe y' by Client S rd <br /> Sign Sign &"la,, S <br /> Print Print .A K2Q ,ci5Adl Th Client Contact 712W- Brbw <br /> cowany vat Company -V <br /> Time (h - Date R l i qi, Time Date l'1 112 Client Phone � <br /> SECORCVSTRECRev"4 Date 1 1 / 1l / Pageof <br /> -�-1! <br />