Laserfiche WebLink
I <br /> Chain of Custody Number 1a3 6 <br /> SECQR Chain-of Custody Record <br /> Field Office 077 Sacramento E) Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name 7-Eleven Store#21756 <br /> Rancho Cordova,CA Location 853 East Yosemite Avenue <br /> Manteca,CA <br /> Project# 77EL.21756 05 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchtedonie <br /> 0 <br /> Laboratory Kiff Analytical e <br /> W <br /> Turnaround Time Standard s <br /> o ^ a g > �€ <br /> Samplers Name Tan Miller a a a W m v <br /> C 16 <br /> Samplers Signature °O g g m 4 N a <br /> LO = E m S EComments/ s <br /> Sample ID Date Time Matrix HE Instructions z' <br /> MW4 /15' Water x X X 3 <br /> MW-2 )It&, Water x X X 3 C-2 <br /> MWS y Water x X X 3 03 <br /> MW-4 Water x X X 3 04 <br /> Special Instructions/Comments Relinquished by .� Received by Sample Receipt <br /> 5 Oxygenates-TAME,MtBE,EtBE,TBA,DIPS Sign �r Sign Total no of containers <br /> Global ID#70607700549(SIRC) Print 2&= <br /> „_ J,,, ,-,L_ Print Chain of custody seals <br /> email EDF to dacatlln@secor corn Company fi�9 — Com Recd in good condition/cold <br /> email lab report to dherzog@secor com Time Date Z.r/_a Time Date Conforms to record <br /> Relinquished by Received by <br /> SignSign Client SECOR <br /> Pnnt Print Client Contact Tom Miller <br /> Comp Company ;Fl= r Client Phone (916)861-0400 <br /> Ti Date Time 1 Ysf 5 Date a t(o 5 ext 279 <br /> ceoaa cusraec a--2 <br /> Date . -f f-o sr Page ' <br /> I <br />