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Chain of Custody Number LY V'& y <br /> SECOR Chain-of Custody Record <br /> FFietd Office 077 Sacramento E3 Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name 7-Eleven Store#19976 <br /> Rancho Cordova,CA Location 1399 North Main Street <br /> Manteca,CA <br /> Project# 77EL.19976.05 Task# 0410 Analysis Request <br /> Project Manager Damon Brown <br /> Laboratory _ Kiff Analytical <br /> n W tg <br /> Turnaround Time Standard d _ <br /> W p a m V o e <br /> Samplers Name Co n W a > � ' m ° <br /> '$ U U <br /> Samplers Signature E °° N <br /> Y6 z z a ; �° E 'Z Comments/ E <br /> Sample ID at Time Matrix z ip i �, m W Instructions z' <br /> MN►-1 Water x X X <br /> 3 � <br /> MW-1A 17,31 Water x X X 3 t <br /> f MW-2 1431 Water x X X 3 9 <br /> F MW-3 34/ Water x X I X 3 <br /> a u <br /> MW-4A 0 S Water x X X �� .e,i ��.d <br /> * ��, t! 3 <br /> MW-5 9 Water x X X 3 <br /> MW-5A 1353 Water x X X 3 <br /> Iw MW-6 Water x X X 3 l <br /> MW-7 1553 Water x X X 3 <br /> Special Instructions/Comments i Rehnquis y�r91Q� NN/(r Received by Sample Receipt <br /> 5 oxygenates:TAME, MtBE, EtBE,TBA,DIPS Sign Sign Total no of containers <br /> Global ID#70607700750(SIRC) Print Print Chain of custody seals <br /> email EDD to eryan@secor com Company -. Compan Recd in good condition/cold <br /> email lab report to dherzog@secor.com and Time Date Tim Date Conforms to record <br /> dbrown@secor.com Relinquished by & 1Received <br /> ,� Sign Sign Client SECOR <br /> Teaw Tt►erm iDe 1�- Print Print Client Contact Damon Brown <br /> Company Company Client Phone 916 861-0400 <br /> Date Time Date Time LCIp _Da_�MZ> ext 230 <br /> 5ECMC R.„ <br /> Date \0 Page 0 <br />