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If13104 AE 161 <br /> Chain-of Custod NwTiber' <br /> SECOR Chain-of Custody Record U �Q 3� <br /> Field Office �I U Additional documents are attached, arid are a part of this Re*brd <br /> Address f II Job Name � OiL lxekrz r <br /> [[ Location 1000 ,�AST /G�lv� � <br /> II 40c�� D,CA , 11 <br /> Project# 770F ,Wl Task# II Analysis Request II <br /> Project Manager. DP <br /> Laboratorym y N <br /> Turnaround Time <br /> m oa b in U2 o M <br /> �� a y U <br /> Samplers Name U w a a� > °'-- m IL o <br /> o o m aN po roo �o m¢ ro a. m <br /> Sampler's Signature m o d N o °N o <br /> U <br /> U d 0 (O CLL O O O c��l m o N m 0 p v U Comments/ 3 <br /> Sample ID Date Time Matrix = � a( >rn _ 10 4 00 .2 N a Instnictions z <br /> p, Y.-7 G <br /> I[ a <br /> w- (153 I I[ <br /> w- I II <br /> MW-1 <br /> MW-11) 1 Iwo 30 Z-o .5-k <br /> Special Instructions/Comments Relin h d Received by II Sample Rceiet <br /> b%0_5 � 7000 �� • Sign + Sign Total no of containers <br /> Print d Print Chain of custody seals <br /> 116- f -030 Company _tpV Company e e.� Ric'd in good condition/cold <br /> Time_l ,3 Date 4z- Time f?Date 3 S a Z Conforms to record <br /> Relinquished by Received by <br /> Sign �� n Client <br /> S� <br /> g 1[ <br /> Print Print Client Contact <br /> Company Company p y Cllient Rhone <br /> Time Date Time Date II - Y-7-SECOR CUSTREC Rev?199 <br /> Date / I[/ Pagq�_ of <br /> ! • <br /> I[ - <br />