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Chain-of Custody Number, 2 5 6 2 <br /> SECOR Chain-of Custody Record <br /> Field Office 077 13 Additional documents are attached, and are a part of this Record <br /> Address3017 Y-115o+'t {Zoa A' S!. Wo _ Job Name R nC h r i- <br /> I ' <br /> 2a nC�a Cor8ovq, CA- 99-67o Location 135-LA Sg n+a r-e RwJ <br /> Protect# 0-9. 4108 002 Task# Analysis Request <br /> Project Manager) LOA+ .r(o nif— <br /> Laboratory-V— <br /> fLaboratoryK—Er- 1:na%y E,'C-A <br /> Turnaround Time lLi <br /> Sampler's Dame i CitAre m la o 0o <br /> Sampler's Signature --�+ � c �, € a N m$ ,N�o <br /> z o N o , . o a = m v Comments/ <br /> Sample ID nate Time Matrix = _ ^ a Instructions z <br /> 1 d pads gio—r <br /> Specianstructions/Corgrnepelinquished by Received by Sample Receipt <br /> n r — Sign Sign Total no of containers <br /> Print �'�'� Print Chain of custody seals <br /> Company SMC-Ok Com y <br /> Recd in good conditron/cold <br /> Time WS Date i I e Date <br /> Conforms to record <br /> Relinquished by Received b Client �LCo R <br /> Sign Sign's- A'6 _kLy r1,11. <br /> Print Print 1'r-Onflif w��oc d�- ` Client Contact.k*kw_hf"A. <br /> Com Company V,4 , Sbl_0>�� <br /> e Date Time k k's Date otio,ol 01M ZZ Client Rhone � <br /> s�cusraEc a.,,VW <br /> Date g l l 0 Page__L of+ <br /> I <br />