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Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento E) Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100Job Name 7-Eleven Store#20632 <br /> Rancho Cordova,CA Location 4627 Da Vinci Drive <br /> Stockton,California <br /> Project# 77EL 20632 03 Task# 0410 Anal is Request <br /> Project Manager Jaff Auchterlonte <br /> Laboratory Kiff Analytical <br /> Turnaround Time Standard <br /> Samplers Name � op a m chi <br /> Samplers Signature tlD ° N ' s <br /> g = _ x a $IS Comments/ <br /> Sample ID Date Time Matrix = a $ a _ u ,� m Instructions z' <br /> MW-1 Y-1-7 )Y Water x X X a/ 3 <br /> MW-2 a 7-y 3 0o Water x X X 3 <br /> MW-3 r7 .7/ Water x X X 3 <br /> MW-4R Z ay 3 y Water x X X oY 3 <br /> MW-5 izw/ 3a Water x X I X Os 3 <br /> MW-6 l7 va Water x X X GC 3 <br /> MW-7 G ,� il3o Water x X X 07 3 <br /> Special Instructions/Comments Relinquished b Received by Sample Receipt <br /> 5 Oxygenates TAME,MtBE, ELBE,TBA,&DIPE Sig Sign Total no of containers <br /> Global ID XT0607700798(SIRC) Print _r,r/,,�� Print Chain of custody seals <br /> email EDD to dacathn@secor com Company �$'__ � Compan Recd in good condibon/cold <br /> email results to dherzog@secor com and Time Date Ti Date Conforms to record <br /> Warey@secor com Relinquished by Received <br /> Sign Sign Client SECOR <br /> Print Print 11,4 zH•Y Client Contact Brian Carey <br /> Company Company Client Phone {916)861-0400 <br /> TiDate Time Date aY� ext.241 <br /> 10 <br /> SEMR 41STREG RAW 2= <br /> Date ; sc Page • <br />