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Chain of Custody Number 0 <br /> SECQR Chain-of Custody Record <br /> Field Office 077 Sacramento El Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name 7-Eleven <br /> Store#20632 <br /> Rancho Cordova,CA Location 4627 Da Vinci Drive <br /> Stockton,California <br /> Project# 77EL 20632 03 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchtedonie <br /> Laboratory Krff Analytical <br /> Turnaround Time Standard z _ <br /> Yl c . O <br /> Sampler's Name ?941,— f } S ' - m <br /> Sampler's Signature m a° co <br /> N 14 <br /> z = r = a p Ei?j ` Comments/ E <br /> Sample ID Date Time <br /> Matrix = $ m =; m �, W Instructions z' <br /> MW-1 - -er l Y51 Water x X X ©/ 3 <br /> MW-2 /v- -s Water x X X pZ 3 <br /> W-3 Y a- -1 1 Water x X X G3 3 <br /> MW-4R a -#Y Water x X X py 3 <br /> to W-5 -to-s-61 z5 Water x X X 3 <br /> MW-6 - e y I al' Water x X X 0 6 3 <br /> W'7 jo- -o 51 S Water x X X 07 3 <br /> I <br /> Special Instructions/Comments Relinqutsh y Received by —Sample Receipt <br /> S Oxygenates;TAME,MtBE,EtBE,TBA,&DIPE Sign Sign Total no of containers <br /> Global ID#70607700798(SIRC) Pnnt Pnnt Chain of custody seals <br /> email EDD to dacatlin@secor com Company rcvCompan Pieta in good condition/cold <br /> email results to dherzog@secor corn and Time Date &p.p_,y TI Date Conforms to record <br /> tmiller@secor com Relinquished by Received <br /> Sign Sign Client SECOR <br /> Print Pnnt #1w Client Contact Tom Miller <br /> Compa Company K ^= e±yAttLN Client Phone (916)881-0400 <br /> TI Date Time Date ext.279 <br /> setae CUSTP=%.vae <br /> Date page <br />