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Chain of Custody Number: <br /> Stantee Chain-of Custody Record <br /> Field Office: 077 Sacramento D Additional documents are attached, and are part of this Record. <br /> Address: 3017 Kilgore Road, Suite 100 Job Name: Proposed 7-Eleven Store#36084 <br /> Rancho Cordova, CA Location: 620 Eleventh Street <br /> Tracy, CA <br /> Project# 185750114 Task# 201.0400 Analysis Request <br /> Project Manager Danielle Manning <br /> Laboratory Kiff Analytical m N ` <br /> v <br /> Turnaround Time Standard � a = � ;� � �, � • <br /> dd <br /> 0 N O 03 <br /> Sampler's Name ; ' dc m <br /> g <br /> Sampler's Signatur0o ° 02o z <br /> NV O O 1 m <br /> > N <br /> Sia oy Em - m <br /> Sample ID Date Time Matrix q ' $f E Comments/ a <br /> U a a o a o o N o d N E <br /> a m > �o x m m m Instructions z <br /> G1?_-A 3 losoil C <br /> .xrvrt - /e. 1 CX <br /> 5 b as c z <br /> -is 3 11\0 14 1 C3 <br /> �P- ti - t3 <br /> Special Instructions/Comments RelinqujoTd by: 5Amgj( ,Z Received by: Sample Receipt <br /> Sign 6 Sign Total no,of containers: <br /> email lab report to danielle.manning@stantec.com Print �0(MR AISft Print Chain of custody seals: <br /> and deborah.lichtenberger@stantec.com Company Stanec Comp Recd in good condition/cold: <br /> Time ��Date Ti Date Conforms to record: <br /> Relinquished by: Received by: <br /> Sign Sign Z Client: Stantec <br /> Print Print T,w y Q� tiu� Client Contact: Danielle <br /> Comp y Company Kiff Analytical Client Phone: (916)861-0400 <br /> TimDate Time _L D7 USIB/� ext. 241 <br /> SECOR CUSTREC Rev.1/BB <br /> Date: S Page / of <br />