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€ <br /> I <br /> ,� Chain-of CustodyNum <br /> ber• <br /> SECOR Chain-of Custody Record <br /> Field Office II Additional documents are attached,land Eire Xart of this Record <br /> Address < � S ?' q Job Name <br /> dn6c�c r�-+� �.�' Location 1 Yd z5 HProject# 7. Zsk� TT1,11 <br /> Analysis Request II <br /> Project Manager 11 110 <br /> Laboratory �► £ <br /> (�N m U 12 <br /> Turnaround Time =o � � m <br /> �� oLO 6 @ c <br /> Sampler's Name _ m� -20 a <br /> Sampler's Slgnat m LIE <br /> °0 `-'N � c o o¢ Co. ro m � C o <br /> 2 N 4M E� m� omE� ; �� o« aSam !e ID to me Matrix = F m LL ¢ w = �, ci w r°t CL Con�ments/ E <br /> Insbvct€ons Z <br /> r <br /> II II <br /> II <br /> Al II <br /> i� II <br /> II II <br /> it II <br /> II II <br /> �I II <br /> Special Instructions//Comments Relin u ' Il <br /> q ReceUby II Sam !e Rece€ tSig Sign Total no of conta€ners <br /> Print Printti <br /> Company II Chain of custody seals <br /> Compan���D �_ Rec'd in good conddion/cold <br /> Time Dated Time <br /> I� Conforms to record <br /> Rehnqui d by Recei b II <br /> Sign a Sign Ilhent <br /> Print Print Client Contact �� <br /> Company 9� ���' Company 11 <br /> Rev v2MTime G Date 5' 15 d Time J��_Date D3 Client Phone <br /> sECOR Cu51REC <br /> 0of <br /> Da#e I f�I IP-5; ,L <br /> €i <br />