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• <br /> i • <br /> Chain-of Custody er <br /> SECOR Chain-of Custody Recordrab Lf CR�_7 <br /> Field Office A _ Additional documents are attached, and are a part of this Record <br /> , . 7t4d Jab Name �, f <br /> Address / <br /> Location <br /> 9--4 5<:! 7�5 <br /> Project# # Analysis Request <br /> Project Manager 7� d !',04_1^V r y <br /> Laboratory c�� t�N coUE2 <br /> Turnaround Time_ a = y c ma w <br /> ❑ a, <br /> _ o a m� n y U <br /> Samplers Na �� $ a m u N p c Q a o mom m a° <br /> Sampler's Sig at cr-. - _* in m m �m 'Fe U m y a <br /> U a o n.a a °o o o m N V o o v V Comments/ <br /> Sam le _ Time Matrix ~� i-� �- ta r(0 N to a� Instructions z <br /> lzrz <br /> Special Instructions/Comments R IEnqui Received b Sample Receipt <br /> S1 Sign �05T ' Total no of containers <br /> I'nn Asn Print___(A-vrc- C-f7 Chain of custody seals <br /> Company. Company �� �-�+ Recd in good condition/cold <br /> Time f�'` Date Time ?.t ate ey Conforms to record <br /> Relinquished by Received by Client <br /> Sign Sign <br /> Print Print Client Contact <br /> I <br /> Company Company Client Phone 74— 3; I <br /> Time Date Time Date <br /> SECOR C1137REC Rev 2A0 <br /> Date 71 .2-j 1 (2� Page 1 of/ <br />