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0 Chain-of Custody Number 2� <br /> SECOR Chain-of Custody Record <br /> Field Office 6-7-7 additional documents are attached, and are a part of this Rei6rd <br /> Address 701`7 &1 urefl-E tzz+ -A/4)j2___ Job Name ��4 45.r - <br /> �r,-tiC�}rp 9S6'7a Location ✓ "+0 <br /> Project# 1071. '?ZOOTask# 2 OJ Analysis Request <br /> Project Manager Z&EE &m tfLu e <br /> Cn <br /> Laboratory I r7-17F cD o 2 N <br /> Turnaround Time / UJk - N <br /> 20 <br /> 0:6a m �� o O� m m a�� o <br /> Sampler's Name ak4 541 2 w a "..5 <br /> U o o m uop o o U a <br /> ' m £ E N m oa' co <br /> EmSampler's Signature o 6aad o <br /> �— Comments/cu ai N o <br /> Sample ID Date Time Matrix 0. ED LO aCO r- n2 <br /> oa <br /> Instructions z <br /> 46 asp l-fo�p - cit <br /> _gyp08nr ✓ / _oma <br /> - qw <br /> 0130 ✓ o <br /> JA <br /> -Zr 044 <br /> rr3 ao -og <br /> A/-J� ll�� ✓ - cv <br /> Special Instructions/Comments Relinquib Received by Sample Receipt <br /> Sign Sign Total no of containers <br /> Print Print Chain of custody seals <br /> Company Company Rec'd in good condition/cold <br /> Time 11Date 7 �4 ✓► Time Date Conforms to record <br /> Relinquished by Received Client <br /> Sign Sign <br /> Print Print 144 - AA L! Client Contact <br /> Company Company <br /> Time Date Time r r Date 7 vOJ Client Phone <br /> SECCR CUSTREC Rev 2f99 <br /> Date 7 / 21( / 0 0 Page—! of 3 <br />