Laserfiche WebLink
Chain of Custody Number <br /> SECQR Chain-of Custody Record <br /> Reid Office 077 Sacramento Q Additional documents are attached, and are pthis Recd <br /> Address 3017 Kilgore Road,Suite 100 _ Job Name Time Oil AW <br /> Rancho Cordova CA 95670 Location x14000 East Highway 88 <br /> Lockford CA <br /> Project# 770T.41737 00 Task# 0003 Analysis Request <br /> Project Manager Todd Brown W a <br /> Laboratory ExelChem a m 1 <br /> Turnaround Time Standard co W a^ m <br /> s pig �3a � o� n <br /> Sampler's Name Brad Blan hip x m '� q �' _ <br /> cw �` cc oo m a m <br /> Sampler's Signature m m N �, o ? N o J <br /> a <br /> U z � -51 E � Comments/ E <br /> � � � c � �Time Matrix z to � m 6 r � a m i io 0 m a m <br /> Sample ID Date a Instructions z' <br /> MW-1 6 <br /> MW-2 /1'2Water X X d 6 <br /> MW-3 1301 g Water X X W,3 5114 6 <br /> MW-4 /b3 /SS f Water X X 6 <br /> MW-5 X x 6 <br /> MW-6 Water X X lD 6 <br /> MW-7 Water X XW 100,H) <br /> s <br /> MW-8 111-Af e3 NAA Water X X 0 6 <br /> MW-9 Water X XW'♦U 6 <br /> MW'10 a er X X 6 <br /> Special Instructions/Comments Relinquished by Received b - (r,,,, Sample Receipt <br /> EDF Required, Please Email Stacie Hartung at Sign Sign - Total no of containers <br /> shortung@secor.com Print Brad Blankenship Print Chain of custody seals <br /> Coma SECOR Company Company p Y ak!'el[t19 Recd in goad condihoNcold <br /> Fax Results to- Time Date - Time 51 Date tv- 2-t Conforms to record <br /> 1)Todd Brown tax 916-861-0430 Relinquished by Received by <br /> Sign Sign Client Secor <br /> Print Print Client Contact Todd Brown <br /> Company Company Client Phone 916-861-0400— <br /> Time Dat— Time Date ext.233 <br /> BECOR d1BiREC Rav 289 <br /> Date le �3 Page 1 of 2 <br />