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Chain of Custody Number 1go <br /> low <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#20632 <br /> Rancho Cordova,CA Location: 4627 Da Vinci Drive <br /> Stockton California <br /> Project# 77EL.20632.05 Task# 0410 Analysis Request <br /> Project Manager Damon Brown <br /> Laboratory Kiff Analytical <br /> Turnaround Time Standard <br /> Samplers Name Co as <br /> Samplers Signature E o .9 A o ; N cc <br /> a ilr <br /> 91 _ T = o S W '` Comments/ e <br /> Sample ID Dat Time Matrix = W � m ; s m n m b W Instructions z <br /> MW-1 1(03 Water x X X 3 0 <br /> MW-2 k3X Water x X X 3 <br /> Mw4 Wk t water x X X 3 <br /> MW-4R NO Water x X I X 3 0 <br /> MW-5 115 ' Water x X X 3 <br /> MW-6 to Water x X X 3 <br /> MW-7 1 Water x X X 3 <br /> Special Instructions/Comments Relinquis Peg" vffpAtw ived by: Sample Receipt <br /> 5 Oxygenates:TAME,MtBE, EtBE,TBA,& DIPE Sign Sign Total no,of containers: <br /> Global ID#70607700798(SIRC) Print Print Chain of custody seals: <br /> email EDD to cryan@secor.com Company Company Recd in good oondition/oold: <br /> email results to dherzog@secor.com and Time Date to Time Date Conforms to record: <br /> dbr+own@secor.com Relinquished by: Received y: <br /> SSign Client: SECOR <br /> �11111111111114- slren+n.tD'9 <br /> Print Print $,'qq w Ar Client Contact: Damon Brown <br /> Tamp lases 1� S Company Company r' A,ti, ( Client Phone: (916)861-WO <br /> In1tM1 coot.M prsssM��7l Time Date Time ra� Date D O ext.230 <br /> mcm cPw. <br /> Date: w �/v5_ Page <br />