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Cham of Cu!! Number <br /> SECOR Chain-0f Custody Record <br /> Field Office 077 Sacramento 0 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,CA <br /> Project# 7TEL.14117 Task# 0410 Analysis Request <br /> Protect Manager Jaff Auchterfonle a <br /> Laboratory Kiff Analytical m W m <br /> vi m C <br /> Turnaround Time Standard <br /> t o p � > o , t <br /> Samplers Name Damon Brown >e $ o o °° A ea <br /> Sampler's Signature o �o m m $� m J <br /> a a p Comments! <br /> Sample ID Date Time Matrix = �0 r m m >III:m m w _ r- ,yj Instructions Z <br /> VIS U, Soil .X X <br /> 4h <br /> Special Instrucbons/Comrnents Relinquished by Received by Sample Receipt <br /> Sign Sign Total no of containers <br /> email results to, dbrown@secor com Print Damon Brown Print Chain of custody seals <br /> dherzog@secor.com Company SECOR Compa Recd in good oonddionlcold <br /> DD to; 0 'J&"@CACOe. <br /> Time Date i T Date Conforms to record <br /> Relinquished by Received by <br /> Sign Sign Client SECOR <br /> Print Print G Client Contact Damon Brown <br /> Com Company Kiff Ana tical Client Phone 916 861.0400 <br /> Time Date Time s _Date 0 ' ext.230 <br /> Sam cwrnec R-yao <br /> Date Page^ 1 of'x. <br /> I <br />