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A.. Chain-of Custody Number <br /> SECOR Chain-of Custody Record <br /> r9oZe�7(p <br /> Field Office © Additional documents are attached, and are a pa o is Record <br /> Address Job Name <br /> j Location <br />� Analysts bequest <br /> Project# � Task# <br /> Project Manager 7bAD 5kiNVAI <br /> V <br /> Laboratory aSEY m 4 <br /> y Jb <br /> Time a � <br /> Turnaround -1 m <br /> 22 3 06 CO <br /> CD LD 6 0 0 <br /> �- CL <br /> a 'a t Sampler's Name a o o o <br /> miN a ,y c Sampler's Si natue � 6oo °m oo- 1. <br /> o Sam le ID Date Time Matrix z �co ¢0coU)wa <br /> m <br /> w M d Instructions z <br /> 1A1659 UAM X. a <br /> _ MW_ /D fIto <br /> Yy UJ w wa0-1 0 l�y <br /> VA UJa 05 <br /> tx.1� S v o G <br /> Special Instructions/Comments Relinq sh d Received by Sample Receipt <br /> Sign Sign Total no of containers <br /> Print MACUZ Print Chan of custody seals <br /> Compan Company Rec'd m good condition/cold <br /> Time Date4 Time ate Conforms to record <br /> Relinquished by Receive Client S&MA <br /> Sign Sign <br /> Print Print Client Contact D(V w <br /> Company Company <br /> Time Date Time 7 at ti Client Phone <br /> SECOR ousTFEc PbW 2M <br /> Date 7 / /62- Page of <br />