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Chain-of Custody Nu <br /> t SECOR Chain-of Custody RecordC�. j <br /> Field Office Z)77 Q Additional documents are attached, andhathis Record <br /> Address .'RD/7 /V' �o�d �i'.7`� lG�. Job Name ep o <br /> Location <br /> Proect#7af 1173 7.�'ask# 2 °,- Analysis Request <br /> 1 <br /> Project ManagersI�AN goLu <br /> LaboratoryG�-I <br /> dl ID <br /> Turnaround Time ' Q <br /> -- _ <br /> ma m m� o y ar <br /> u� � O� m c <br /> o <br /> Sampler's Name o a LM 0) " a N <br /> 1- 0 o w 2o po quo °o mo a°r m o <br /> SamplersSignatu a "1 m1 rnm ' m J <br /> oN y m `"+momo f ' <br /> Comments/Sam le ID to a Matrix 2:(D <br /> U)(0 a co n a b Instructions Z <br /> Q.se L <br /> � 13 ZDD3 <br /> Special Instructions/Comments R <br /> quish Received by sam le Receipt <br /> t� ,p Sign Total no of containers f <br /> ^ �.. nt Chain of custody seals <br /> Company Companyxral CLl Rec'd in good condition/cold <br /> 861 `0430 Time 13 :S"4 Date z�3 Tlme!3LS� Date a <br /> J -- J Conforms to record <br /> Relinquished by Received by Client —O <br /> Sign Sign <br /> Print Print Client Contact <br /> Company Company g6 <br /> Time Date Time Date Client Phone <br /> sEOM our R,2M <br /> Date / a Page of 1 <br />