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Cham of Custody Number <br /> SECOR 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 .lob Name 7-Eleven Store#20632 <br /> Rancho Cordova,CA Location 4627 DaVincl Dr <br /> Stockton,CA <br /> Project# 77EL20632.04 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonie <br /> Laboratory Kiff Analytical q <br /> Turnaround Time Standard m <br /> Q m W , <br /> Sampler's Name Damon Brown m Ira 3 <br /> amplet's Signature o m o � �E <br /> Sample ID Date Time Matrix r 40 <br /> r E x a Comments/ s <br /> U a �� >°m r4D r°nm �w F-UJ Instructions z' <br /> - SB- ls 01/31/05 17 YS Soil X X 1 <br /> 5er' <br /> t <br /> B — 31-� It V5- 15s,J <br /> X X <br /> Sg 3 91 f 3r o 13'55 <br /> 5(j 3C r� jp "f'40 ?� l <br /> t+f l 1910 1 56A <br /> Special Instructions/Comments Relinquished by Received by Sample Remipt <br /> Sign Sign Total no of containers <br /> email results to, dbrown@secor com Print Damon Brown Print Cham of custody seals <br /> dheizog@secor.com Company SECOR Com Redd in good condthonlcold <br /> Time 16:zy Data Z Date Conforms to reoord <br /> Relinquished by Received b <br /> Sign Sign Client SECOR <br /> Print Pnnt Client Contact Jaff Auchterlonle <br /> Compan Compa Kiff Analytical Client Phone (916)861-0430 _ <br /> Time Data: Time �j Date nLn� = ext 223 <br /> swat cusr�c�� <br /> Date 01131105 Page 1 of 1 <br />