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Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento <br /> Address 3017 K11ore-Road,Suite 10o Ll Additional documents are attached, and are part of this Record <br /> Job Name 7-Eleven Store#17334 <br /> Rancho Cordova,CA Location 4501 North Pershing Avenue <br /> Stockton, CA <br /> Project# 77EL.17334 04 Task# 0410 <br /> Project Manager Jaff Auchterionie — Analysis Request <br /> Laboratory Kiff Analytical -- <br /> Turnaround Time Standard a -, a 2 <br /> z 4 m <br /> p a <br /> Sampler's Name Tom Miller m 0 g <br /> o <br /> Sampler's Signatur �' � <br /> � pp yO l�0 �O O <br /> : a ro $ .� a a .mss a m <br /> Sample IIT Date Time Matrix g o Comments) 3 <br /> MW-20 in Instructions z <br /> -7-c y 1+x�l Water x X X I MW-3 3 y 7-ay 24s— Water x X <br /> X 3 <br /> MW-4 7-0 /330 Water x X <br /> izx+— <br /> Mw-5B <br /> 3— <br /> V---7-a 1 r Water x X <br /> 3 <br /> Y-7-o /� Water x X <br /> X 3 <br /> Special Instructions/Comments RelinquishedMb ! Received b <br /> 5 Oxygenates TAME, MtBE, EtBE,TBA, DIPS Sign Si n y <br /> Sample Receipt <br /> Global ID#70607700407(SIRC) Print g Total no of containers <br /> email EDD to dacatiin@secor com Com Pont Chain of custody seals <br /> Company <br /> email results to dherzo p y Compan Recd in good conditron/cold <br /> g@secor com and Time 2 Date P%4,0 Date Conforms to record <br /> bcarey@secor com <br /> Relinquished by Received by <br /> Sign Sign Client SECOR <br /> Print Print , Client Contact Bnan Carey <br /> Com Company Client Phone 916 861-0400 <br /> $ Date Time 9—Date ext 241 <br /> SECM CUSTREC Rei 7/B� <br /> Date ell- 7-0Page / <br />