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Chain-of Custody Number: <br /> SECOR Chain-of Custody Record <br /> Additional documents are attached, and are a part of this Record. <br /> Field Office: L <br /> Address: f S Job Name: <br /> 3 a ar✓ <br /> Location: <br /> Analysis Request <br /> Project# 0 S � ' � Task# <br /> Project Manager <br /> Laboratory "$ <br /> 2 <br /> Turnaround Time aKe <br /> a 8 o m� m" <br /> d .o rn( O0 � � yUJ <br /> `o <br /> a <br /> Sampler's Name m E E ° y o roroO o o° a° E <br /> ;p jp0 N O ?N _O J �`h <br /> Sampler's Signa U d o d o a E o o N ro o d N o e U Comments/ Z <br /> Sam le ID Date Time Matrix = r Instructions <br /> — -3 3 o ' <br /> _ 6 .3 q <br /> S � <br /> -s 2,s <br /> S .S ..S <br /> Nag <br /> Spec�ia(l,Instructions/ omments: Relinquis y: Total no.of containers: <br /> 0 Sig <br /> Ly � �{yj.s'�((1Je�( fl � Print i S ld Print Chain of custody seals: <br /> Company S Company Rec'd.in good condition/cold: <br /> Time Date Time d Date Conforms to record: <br /> Relinquished by: Received b Client: <br /> Sign � 4!:� Sign <br /> Print /e/ Print Client Contact: <br /> Company Company <br /> Time / 6u Dated Time Date / Client Phone: <br /> 6mwsrRE .eros <br /> Date: 3Z Pageaof <br />