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i <br /> Chain of Custody Number 3 7(o 9 Z <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento L3Additional documents are attached, and are part of this Record <br /> Address 3017 IQI ore Road Suite 100 Job Name 7-Eleven Store#19976 <br /> Rancho Cordova CA Location- 1399 North Main Strut <br /> Manteca.CA <br /> I <br /> Project# 77EL.19976 04 Task# 0410 alysis Request <br /> Project Manager Jaff Auchterionie <br /> Laboratory I(lff Mal cal <br /> Turnaround Time Standard x s ° <br /> Sampler's Name Tom MillerEll 1 <br /> Samplers Signa °° o ° <br /> m a Comments/ <br /> Sample ID Date Time I Matnx s s 8 rR io °�w Instructions z' <br /> MW-1 a , 69/ Water x I X I I I I X _01 3 <br /> MW-1A 3 3 00 Water x X X -02- 3 <br /> MW-2 3A 1/. 1-736 Water x X X -03 3 <br /> MW_3 '% s 3-i V water x X X -oL{ 3 <br /> MW-4 , _ OV Water x X X -05 3 <br /> MW-4A 3 ,s .., //30 Waterx X X -0(0 3 <br /> MWS , 60 Water x X X -01 3 <br /> MW-SA S»' Water x X X -o$ 3 <br /> MW-6 31 ,V Water x X X --og 3 <br /> MW-7 3 = 34> Water x X X -t o 3 <br /> Special Instruchons/Comments Relinquished b Received l:y Sample Receipt <br /> 5 Oxygenates:TAME, MtBE, ELBE,TBA,DIPE Sig Sign Total no of containers <br /> Global ID#70607700750(SIRC) Pnnt Print Chain of custody seals <br /> email EDD to dacatiinfsecor.com company Comp Recd in good conddion/oold <br /> email tab report to dherzogf secor com and Time ,ft— Date o o ymfe Date Conforms to record <br /> bcairey@secorcom Relinquished by Received by <br /> Sign Sign Client SECOR <br /> Print Print Client Contact: Brian Carey <br /> Com Company K, eod Client Phone (916)881-0400 <br /> e Date Time g`I DaleO3� ext.241 <br /> SEOM CUBTF&C,- <br /> Date p/y .. Page <br />