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r <br /> 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 K11gore Road,Suite 100 . Job Name: 7-Eleven Store#14117 <br /> Rancho Cordova,CA Location: 2725 Country Club Lane <br /> Stockton,CA <br /> Project# 77EL.14117.03 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterionie a <br />! Laboratory Klff Analytical °� c e <br /> W co <br /> Turnaround Time Standard �. c0 N m 5�, ^ <br /> a o <br /> O n d <br /> 1 m En o , <br /> W O <br /> Sampler's Name ia+n '� g " m <br /> m <br /> Sampler's Signature m °r m " m m p o N <br /> m m S m Comments/ a <br /> Sample tD Date Time Matrix � A fL- $ _ N m I- Instructions z <br /> D1 ABCD Soil X X <br /> i <br /> Spedal instructions/Comments Relinquished by. R ived by. Sample Receipt <br /> Combine soil samples SP1A SP1-B,SP1-C,and SP1- Sign Sign Total no.of containers: <br /> C Into one composite sample SP1{ARCD) Print (j-r;aty� Print Chain of custody seals: <br /> Company {� Com Recd in good condiitiontcold: <br /> 5 Oxygenates:TAMEJ,MtBE,ELBE,TBA,&DIPE Time SOO Date V T Date Conforms to record: <br /> Global ID#70607700458(SIRC) Relinquished by. Received by: <br /> email results to bcarey@seor.com SignSign ClientSECOR <br /> email EDF Deliverables to mkach@secer.com print Print Client Contact: Brian Caney <br /> Com Company Client Phone: (916)861-0400 <br />,{ <br /> Time Date Time 11Y00 Date o I•{o.3 ext.247 <br /> �-=° Date: I�7- <br /> 03 Page �,--l'of 1 <br />