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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 ,lob Name Time Oil <br /> Rancho Cordova,CA 85670 Location 14000 East Hi hwa 88 <br /> Lockford,CA <br /> Probed# 770T 41737 00 Task# 0003 Analysis Request <br /> Project Manager Todd Brown <br /> Laboratory ExelChem 4 W Q <br /> c 2 0- <br /> < <br /> Turnaround Time Standard <br /> p m Ui � v C} 3 O D U cn 0 <br /> ti m � paQ = ire 20 —' a <br /> Sampler's Name Damon Minarich a �, 9 c m �, M@ o M d <br /> E m O }- � Q cp o � dao m a <br /> Samplers Signature h x w uj o a °' ' m a Comments/ E <br /> U 0. o Qp Fw" co oN o 4mN wo ov C U 3 <br /> Sample ID Date Time Matrix x i- C r m rn w �o > _ N a r a Instructions Z <br /> MW-1 7 2M 10LI / Water I X X 5 <br /> MW-2 Water X X 6 <br /> :MW-3 I Water X X 6 <br /> MW-4 Water X X 6 <br /> MW-5 <br /> 6 <br /> MW-6 Water X X 6 <br /> MW-7 Water X X 6 <br /> MW-8 / Water X X 6 <br /> MW-9 <br /> t Water X X 6 <br /> MW-10 Water X X 6 <br /> Special Instructions/Comments Relinqui d by Received by Sample Receipt <br /> EDF Required. Please Email Krissy Flesoras at Sign i g n Total no of containers <br /> kflesoras@secor cam Print Da on Minarich I Pnnt Chain of custody seals <br /> Company SECOR I Company Recd in good condition/cold <br /> Fax Results to. Time 2 Date Time Date Conforms to record <br /> 1)Todd Brown fax 916-861-0430 Relinquished by Received by , <br /> Sign Sign Client Secor <br /> Print PnntaLrvm Client Contact Todd grown <br /> Company Company Client Phone 916-861-0400 <br /> Time Date Time Date ext 233 l <br /> SECOR CUSTRsc R«?tori <br /> Date Page 1 of 2 <br />