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I <br /> Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento U Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road Suite 100 Job Name 7-Eleven Store#17334 <br /> Rancho Cordova CA Location 4501 North Pershing Avenue <br /> Stockton CA <br /> Project# 77EL 17334.03 Task# 0410 Anaf sis Request <br /> Project Manager Jaff Auchterlonie <br /> Laboratory Kiff Analytical N' m _ y <br /> cofn d U <br /> Turnaround Time Standard <LU y �_ N <br /> o � wors 0 <br /> �j a, 0.S U C7 7 O ;[ y c <br /> Sampler's Name Tom Miller it 0 0c � <br /> Samplers Signature �? ;? = N o �, a <br /> 150 N d0 ,� N <br /> x = r CL z E a ca E g g< Comments/ <br /> Sample ID Date Time Matrix z m a � n ° Instructions z' <br /> MW-2 n1 Water x XX "b 3 <br /> MW-3 a. A/-C— Water x X X —02 3 <br /> MW-4 a / 30o Water x X X �p 3 <br /> MW-5A /oy Water x X X `° 3 <br /> MW-5B /3Y Water x X X `bS 3 <br /> Special Instructions/Comments Relinquished by R eived by Sam le Receipt <br /> 5 Oxygenates TAME, MtBE, ELBE, TBA, DIPE Sign Sign Total no of containers <br /> Global ID#T0607700407(SIRC) Print �r .., Print Chain of custody seals <br /> EDF Deliverables(email to dacatlin@secor com) Company Compan Recd in good condition/cold <br /> email results to dherzog@secor corn Time ttq(o Date 2 Ti Date Conforms to record <br /> Relmiquished by -Received by <br /> Sign Sign Client SECOR <br /> Print Print ZtZitai A , s Client Contact Briars Carey <br /> Comps Company Client Phone 916 861-0400 <br /> Time Date Time 17-To Date o2l%sDq ext.241 <br /> 7OR OWMEC Rev 2196 <br /> Date / a Page��,= <br />