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i <br /> i <br /> '4' <br /> Chain of Custody Number ,GTS <br /> SECOR Chain-of Custody Record 22-23 <br /> Field Office 077 Sacramento L3 Additional documents are attached,and are part of this Record <br /> Address 3017 VJ are Road,Suite 100 Job Name 7-Eleven Store#20632 <br /> Rancho Cordova,CA Location 4627 DaVincl Dr <br /> Stockton,CA <br /> i <br /> Project# 77EL20632.04 Task# 0410 Analysis Request <br /> Protect Manager Jaff Auchterlonle <br /> Laboratory Klff Analytical m e <br /> Turnaround Time Standard r z <br /> ° a � em <br /> Sampler's Name Darton Brown o o o S <br /> 0 0 <br /> Sampler's Signature _��,.-.,-�-�� g a o s N A a a m 2 <br /> x x E,l gi d Comments! <br /> Sample ID Data Time Matnx x m >V a A Va w w Instructions z' <br /> 7 <br /> (7".0 4."-&/ —[�I t <br /> 5B.- kc- `�31 0� 1�'► U-4 ri <br /> 5 e)- a Pk �3r lam wq.lri K X <br /> -a3 <br /> 5 8 i i i I V(O w t 4qr yC Q t <br /> 5a- ae 'l 15,yr waAir <br /> 56 -3A r 0 13L uea-le! -� <br /> 5 -3B 13 .40 <br /> 5 - ' 14 20 wkipr t� [ <br /> Special Instructions/Comments Relinquished by Received by Sample Receipt <br /> Sign Sign Total no of containers <br /> email results to dbrown@secor com Print anion Brown Print Chain of custody seals <br /> dherzog@secor com Company SECOR Com Reed in good conditionloold <br /> Time !L`to Date 2 c Date Conforms to r000rd <br /> Relinquished by Received by <br /> Sign Sign Client. SECOR <br /> Print PrintMIhLC Client Contact. Jaff Auchterlonle <br /> Com Company Kiff Anal cal Client Phone (916)86/43430 <br /> e Date Time Date exL 223 <br /> BECM CUUrREC Rw WN <br /> Date 01/31/05 Page 11 of 1 <br />