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Chain of Custody Number <br /> SECUR Chain-of Custody Record <br />� Field Office 077 Sacramento U 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 Auchterlonie <br /> Laboratory Krff Anal itcal <br /> N N <br /> Turnaround Time Standard a <br /> a <br /> Sampler's Name Torn Miller 3 = � —' A 0 <br /> - m c� <br /> UJI �, v <br /> Sampler's Signature co N V C a p n cc <br /> O <br /> a m Comments/ 9 <br /> Sample ID Date Time Matrix a 0 o a a s E o a E <br /> ~ m ¢ ° � ta ° � ° to W instructions z' <br /> M W-1 p p 0 Water X X <br /> MW-2 / OO Water X X <br /> MW-333 <br /> /d o� Water X X <br /> MW-4 / W 3 Water X X <br /> I <br /> i <br /> Special Instructions/Comments Relinquished by Received by Sample Receipt <br /> 5 Oxygenates TAME, MtBE, EtBE,TBA, DIPE Sign , r- Total no of containers <br /> Global ID#70607700549(SIRC) Print 72 Pant Crain of custody seals <br /> EDF Deliverables Company .Sc--car Com Recd in good conditiontcold <br /> email results to bcarey@secor.com Time Date a Date Conforms to record <br /> Relinquished by Receiv b <br /> Sign Sign Client SECOR <br /> Print Print F Client Contact Brian Care <br /> Comp Company to "lent Phone (916)861-Mo <br /> e Date Time (3 Date Q I ext, 241 <br /> SECOR CUSTREC Rev 2l99 <br /> Date Page <br />