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Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento , 1I 112 gin* PS; Ll Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 .lob Name Time Oil <br /> Rancho Cordova,CA 95670 Location 14000 East Highway 88 <br /> Lockford, CA <br /> Project# 770T 41737 00 Task# 0004 Analysis Request <br /> Project Manager Todd Brown m <br /> Laboratory ExelChem a o u <br /> Turnaround Time Standard m N a <br /> T Lu a o <br /> xa � <br /> Sampler's Name Ben Wn ht c o m m ;. o <br /> Sample>'s Signature o =�, w m ui - Comments/ <br /> Sample ID Date Time Matrix r � m En ¢ °w Instructions Z <br /> o/61/04 I Soil 0 - {? o� Q tin+�l ► I►�- I <br /> -1� to a 0 t 2 5 - 0 <br /> 5�-ti3 � �5 toD 2 0 Z 5 <br /> _03- <br /> 0 <br /> t� tit�o 0 111 0 2 a - o µo LJ) y <br /> 56.07 @ Z5' RIM <br /> � i <br /> 3a 115-D 0 0 � D <br /> S$-t3 oL35 45-1 X k Z s - 0 4 l <br /> 58-13@. 4D 1 � X lg <br /> Special Instructions/Comments Relinquished b Received by Sample Receipt <br /> EDF Required Please Email Knssy Flesoras at Sign Sign Total no of containers <br /> kflesoras@secor com Print Ben Wright Print 122,1-des,4 Chain of custody seals <br /> Company SECOR Company _ x[F/Cl,�c� Recd in good condition/cold <br /> Fax Results to Time Date Time IYev Date N-S-o Conforms to record <br /> 1)Todd Brown fax 916-861-0430 Relinquished by Received by <br /> Sign Sign Client Secor <br /> Print Print Client Contact Todd Brown <br /> Company Company Client Phone 916-861-0400 <br /> Time Date Time Date ext.233 <br /> SECOR CUSTREC Rev 7N9 <br /> Date 1llozlau Page of <br /> —r" <br />