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Chain of Custodx Number: I&q(513(5JU <br /> Stantee Chain-of Custody Record <br /> Field Office: 077 Sacramento El Additional documents are attached, and are part of this Record. <br /> Address: 3017 Kilgore Road, Suite 100 Job Name: Proposed 7-Eleven Store#36084 <br /> Rancho Cordova,CA Location: 620 Eleventh Street <br /> Tracy, CA <br /> Project# 185750114 Task# 201.0400 Analysis Request <br /> Project Manager Danielle Manning m <br /> Laboratory Kiff Analytical w o <br /> Turnaround Time Standard m T = 2e <br /> M c a ,� yc�7 > O � w c <br /> O N <br /> Sampler's Name w .-"_ 0 9 <br /> O N A <br /> Sampler's Signature m E m o mm o <br /> wu <br /> E 5 s 16 Comments/ n <br /> Sample ID Date Time Matrix = a m a a` _ N F <br /> Instructions z <br /> 11- Gw S 13 `1S Water X 6 O 1 <br /> Special Instructions/Comments Relinquis ed by: SnvWI(o Received by Sample Receipt <br /> Sign ,S --r Sign Total no.of containers: <br /> email lab report to danielle.manning@stantee.com Print Print Chain of custody seals: <br /> and deborah.lichtenberger@stantec.com Company Stantec Compan Rec'd in good condition/cold: <br /> Time Date Ti Date Conforms to record: <br /> Relinquished by: Received by j <br /> Sign Sign `--- Client: Stantec <br /> Print Print j.io y[3cc,.yp� Client Contact: Danielle <br /> Corr Company Kiff Analytical Client Phone: (916)861-0400 <br /> Tim Date Time /03S Date 0,5)313 ext. 241 <br /> V <br /> SECgR CUSTREC Rw.LB3 <br /> Date: S I A13 Page I of <br />