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Cham of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento <br /> Address 3017 Kilgore Road,Suite 100 El Additional documents are attached, and are part of this Record <br /> Job Name 7-Eleven Store#19976 <br /> Rancho Cordova,CA Location 1399 North Main Street <br /> Manteca, CA <br /> Project# 77EL 19976 03 Task# 0410 <br /> Project Manager. Jaff Auchterlome Analysis Request <br /> Laboratory Kiff Analyticalco <br /> n r <br /> Turnaround Time Standard a <br /> _ C N <br /> W CL <br /> C CL m <br /> o <br /> Samplers Name Torn Miller x m o a `" <br /> p vm <br /> W > to au <br /> mm <br /> amSamplers Signature co ur <br /> U <br /> ma� aoo <br /> Sample ID Date Time Matrix " a a ° o o N o (a N o a Comments/ CD10 <br /> Q _ `0rDV� W Instructions <br /> MW-1 9 is-�3 130c, Water <br /> X X Z <br /> MW-1A Water X <br /> X <br /> MW-2 q ",--,v 17"s- Water X <br /> MW-3 9 . s;---.3 X t 3c Water X _3 <br /> MW-4 T �r�� ja-4 ` X <br /> Water X X <br /> MW-4A y' .r-�3 /2-y s- Water X X ^ <br /> MW-5 g �r�3 C Water X X 3 <br /> MW-5A Water X X y <br /> MW-6 5 J=�� I y l Water X X <br /> MW-7 J-"3 L) Water X <br /> X 30 <br /> Special Instructions/Comments Relinquished by1Jli _ Received by <br /> 5 Oxygenates TAME, MtBE, EtBE,TBA, DIPE Sign Sample Receipt <br /> Global ID#70607700750(SIRC) print �� Sign Total no of containers <br /> t Print Chain of custody seals <br /> EDF Deliverables(email EDF to mkoch@secor com) Company f ��� Company <br /> email lab report to dherzog@secor com Time _Date U T Date Recd m good condition/cold <br /> Conforms to record <br /> Relinquished by Received by <br /> Sign Sign tient SECOR <br /> Print Print Client Contact Brian Care <br /> Com pa Company �,{„;� f.{ Client Phone (910861-0400 <br /> Tim Date Time lav L Date ext 241 <br /> SECOR CLK?nc <br /> Rev <br /> Date /r-Q 3 Page��,� <br />