Laserfiche WebLink
I <br /> • Chain of Custody Number • <br /> SECQR Chain-of Custody Record <br /> Field Office 077 Sacramento Q Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name 7-Eleven Store#20632 <br /> Rancho Cordova,CA r Location 4627 Da Vinci Drive <br /> Stockton,California <br /> Project# 77EL.20632 05 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonle <br /> Laboratory Kill Analytical m <br /> Turnaround Time Standard a �' <br /> Samplers Name C•n " "6 m c� <br /> Samplers Signature a e€ s N a N ° <br /> ¢ z T.101, a e $- e Comments/ <br /> Sample ID Date Time Matrix = r r$ 8 m 2 A m n Instructions z' <br /> MW-1 - -�. Water x X <br /> 27 Water x X X 3 0 <br /> S l <br /> MWWater x X X 3 <br /> it MW-4R b Water x X X �'0- *� 3 a3 <br /> • MW-5 Water x X X Y4iM0. 3 � <br /> MW-6 z7 Water x X X 3 oS <br /> MW-7 16yg Water x X X 3 <br /> 6 <br /> coo <br /> Special Instructions/Comments Relinquished VA Received by Sample Receipt <br /> 5 Oxygenates:TAME,MtBE, EtBE,TBA,8,DIPS Sign Sign Total no of containers <br /> Global ID#70607700798(SIRC) Print Prat Chain of custody seals <br /> email EDD to cryan@secor com Company r Company Recd in good condition/cold <br /> email results to dherxog@secor com and Time Date &-6 _o e;- Time Date Conforms to record <br /> dbrown@secor com Relinquished by Received by <br /> Sign Sign Zlient SECOR <br /> Pint Print Client Contact Tom Miller <br /> Company Company Client Phone (916)861-0400 <br /> Time D Time ate p l p � ext 279 <br /> sr:co�arc a��o <br /> Date b $ -a Page III <br />