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• i <br /> Cham of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento Q Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road Suite 100 Job Name 7-Eleven Store#14117 <br /> Rancho Cordova,CA _ _ Location 2725 Country Club Blvd <br /> Stockton,California <br /> Project# 77EL.14117.04 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlome <br /> Laboratory _ Kiff Analytical N a <br /> V <br /> Turnaround Time Standard a V y �' A ; N <br /> wnn m 9 a e <br /> o v io d � ao C:Sampler's Name Tom Miller w H m <br /> Sampler's Signature r <br /> a z = = E S E 'm Comments/ <br /> Sample ID Date Time Matrix riL W z 0 Lo co ° w Instructions z <br /> MW-1 - 3 a 1,5 a Water x X X o 3 <br /> MW-2 - 2 Of a. 00 Water x X X oZ 3 <br /> MW_3 '3-3 oY /YAs Water x X X G-� 3 <br /> MW-4 3-3'ay I1S_ Water x X X 0"1 3 <br /> MW-5 3-3 -y v 3'0 Water x X X 05 3 <br /> MWS ` 'Y Water x X X OL 3 <br /> M W-7 3 a -Y Water x X X 6-1 3 <br /> — MW-8 3' --Y 13,710 Water x X X v 3 <br /> Special Instructions/Comments Relinquished by'-7-�,:. !f'�z, Received by Sam le Recei t <br /> 5 Oxygenates-TAME,MtBE, EtBE,TBA,& DIPE SignSign Total no of containers <br /> Global ID#T0607700458(SIRC) Print -�-- /Cl Print Chain of custody seals <br /> email EDD dacatlln@secor com Company,S'&-r_a. Company Recd in good condition/cold <br /> email lab report to dherzog@secor cam and Time Date Tim Date Conforms to record <br /> bcarey@secor corn Relinquished by Received by <br /> Sign Sign /�� Client SECOR <br /> Print Print N, � S S?4.^�4 Client Contact Brian Care <br /> Company Company �,�c meq,_ Client Phone (916)861-0400 <br /> Time Date Time t V5c> pate 266 ext.241 <br /> SEOWCFWvZW <br /> Date 3 3`o Page o,�/ <br />