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Cham of Custod Number <br /> SECOR Chain-of Custody Record <br /> i <br /> Reid Office 077 Sacramento ❑ 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 03 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonle <br /> a <br /> Laboratory Kiff AnalyiWal i <br /> Turnaround`Gime Standard <br /> all <br /> Sampler's Name Tom Miller 12 <br /> � o � d <br /> 5amples's Signature Comments/ <br /> Sample ID Date Time Matrix s r � a 8 3 18V m w Instructions z <br /> fmm W-1 -/7-u3 /C f Water X XW-2 -o 5— Water X XW-3 y-/7-ws as Water x x '�� eel <br /> v/ MW-4 V-I 7--3 a 3f Water X X <br /> Special Instructions/CommentsRelinquished by calved by Sample Receipt <br /> 5 Oxygenates TAME, MtBE, EtBE,TBA,DIPE Sign Sign Total no of containers <br /> Global Iia#T0607700549(SIRC) Print / 4r•��/lr� Print Chain of custody seals <br /> EDF Deliverables-Email Molly Koch at Company .9e-c Comp Recd in good condaion/coid <br /> mkochgsecor com Time (� Date 8 0 e Date Conforms to retard <br /> email results to bcarey6secor eomsquished by Received by <br /> Sign Sign Client SECOR <br /> Print Print X;.,., A �� Client Contact Brian Carey <br /> Comp Company iC A.,,,Lit�.J Client Phone (916)861-0430_ <br /> e Date Time ±20 Date p y;go3 ext 241 <br /> 12CORWSTRECRw Z <br /> Date i d Page /o gar <br />