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Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field 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 21755 03 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonie <br /> Laboratory Kiff Analyitcal tB m y <br /> Turnaround Time Standard a e <br /> Samplers Name Tom Miller 1 - > <br /> Sampler's Signature o o $ $ P a <br /> X Comments/ <br /> Sample ID Date Time Matrix = $ a $ 1 aI X. <br /> g ° w Instructions z <br /> MW-1 2Zja0 D O Water X X <br /> MW-2 00 Water X X —02 <br /> MW-3 d oi1/0 Water X X <br /> MW-4 Water X X V +� <br /> Special Instructions/Comments Relinquished by Received by Sample Receipt <br /> 5 Oxygenates-TAME, MtBE, EtBE,TBA, DIPE Sign Sign Total no of containers <br /> Global ID#T0607700549(SIRC) Print Print Cham of custody seals <br /> EDF Deliverables Company �yg_.� Com <br /> Recd in gond condition/cold <br /> email results to bcarey@secor.com Time Date rRe <br /> Date Conforms to record <br /> Relinquished by 1v bSign Client SECOR <br /> Pnnt F Client Contact Brian Carey <br /> Comp pany ( 1 ent Phone (976)861-0430 <br /> Date Time i3 Date ext,241 <br /> SECOR CU9TAEC Rw 294 I <br /> Date Page <br />