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Chain-of Custody Number. As ?Dl <br /> SECOR Chain-of Custody Record <br /> Feld Office 0T7 0 Additional documents are attached, anf are a part of this RArd <br /> Address 92 Job Name <br /> ce., Location - Z3 <br /> t J� <br /> Project# d ,`t 3 0+�T sk# Analysis Request <br /> Project Mana er <br /> Laboratory ip <br /> _ 4 <br /> Turnaround Time in = <br /> Sampler's Name IL 3o a o m o a w Q o <br /> Sampler's Signature a r _ o o a �CO <br /> CL <br /> E aO afin y " Comments/le ID NDatTime atrlx = m x m a p Instructions z <br /> --Z c gyp, <br /> Special Instructions/Comments Relin Recei by, Sam le Rec-seilit <br /> Sign �" Sign Total no of containers <br /> Print Print Chain of custody seals <br /> Company Co y Rec'd in good condition/cold <br /> Time X33:3 Date 1 b Time Date <br /> Conforms to second <br /> Re is by'_ Recei by' Client E-GD <br /> Sign Sign d <br /> Print Printf riW . pc Client Contact <br /> Cornpw< Company_ e'if ,A,1A,)71VeA L <br /> Time Date Time /3�_Date GSD S OJ Client Phone <br /> sECM OJSTM RK ZW ---r <br /> Date / / Page I of <br />