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Chain 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#19976 <br /> Rancho Cordova, CA Location 1399 North Main Street <br /> Manteca,CA <br /> Protect# 77EL 19976 04 Task# 0410 Analysis Request <br /> Protect Manager Jaff Auchterlome o <br /> Laboratory Kiff Analytical y N <br /> Turnaround Time StandardCD <br /> a <br /> + m m r"3C7 0U a c <br /> Sampler's !Name Tom Miller w � � � � � 'tM v me R m � <br /> Sampler's Signature-'" 2 m o E ° " 'T o <br /> a. a ° Comments! <br /> Sample ID Date G a N Oa <br /> EU= d umoTrme Matrix <br /> Instructions z <br /> MW-1 &/0- 17 66 Water x X X 3 <br /> MW-1A G/0 /a-,)d Water x X X 3 <br /> MW-2 G /0-017V Water x X X 3 <br /> MW-3 G-/ac /54j'- Water x X X 3 <br /> MW-4 /0- Water x X X 3 <br /> MW-4A Water x X X 3 <br /> MW-5 y0 -Q� `'IJ Water x X X 3 <br /> MW-5A (9-t0-0YK5-&C) Water x X X <br /> 3 <br /> MW-6 ,I0� j 1/yJr Water x X X 3 <br /> MW-7 4-P-(51( oo Water x X X 3 <br /> Special Instructions/Comments Reli Received by Sample Receipt <br /> 5 Oxygenates, TAME, MtBE, ELBE,TBA, DIPE S1w Sign Total no of containers <br /> Global ID#70607700750(SIRC) Print Print Chain of custody seals <br /> email EDD to dacatlin@secor com Company Compan Recd in good conditionicold <br /> email lab report to dherzog@secor cam and Time Date T Date Conforms to record <br /> bcarey@secor com Relinquished by Received by <br /> Sign Sign Client SECOR <br /> Print Print Client Contact Brian Carey <br /> Compa Company Client Phone (916)861-0400 <br /> Ti Date Time I 2S- DatedIryl _ ext.241 <br /> 9ECM CUSTREC Rn 2M <br /> Date ��' page �10,� <br />