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i DO) AJ 0/0 Chain-of Custody Number <br /> SECOR Chain-of Custody Record �K(s <br /> � <br /> Additional documents are attached, and are a part of this RAbrd <br /> Field Office �� - <br /> _�J /rte ` <br /> Address �+ <br /> Location ���2�G J�:,.y 'B�-sr <br /> Analysis Request <br /> -1V;737- <br /> Project#42= mask# <br /> Project Manager <br /> Laboratory c? r_ <br /> Turnaround Time S� a a g) Eno m2 o <br /> o 0 <br /> = m o DC7 m� a m o <br /> Sampler's Name _ <br /> CD E UNO O� NO 3�N �O �`N 2 <br /> Sampler's SI nature m" " a "�m -m o m w m a E <br /> {� g _ 101.r z r = 0 m� m' m c'v v o o v v U Comments/ <br /> Sample ID Matrix = °o a 0D r Q coo 0 z o W(0 Q.(0 F i- a Instructions <br /> A/ 160 <br /> I <br /> Special Instructions/Comments Relinquis Received by Sample Recei t <br /> Sig _ --• Sign Total no of containers <br /> print Print Chain of custody seals <br /> F0. *e s� N-s +o 7--1) g*sin�(9Ib�8bf—n`�3 Company Company Recd �n good condition/cold <br /> Trme �/ Date Time Date Conforms to record <br /> Relinquished by Receive Client v <br /> Sign Sign <br /> Print Print Client Contact <br /> Company Company Client Phone ''1"�'�p <br /> Time Date Time _ Date <br /> SECOR CUS MEC Rea 2/99 <br /> Date Z / ©1 Page_L of <br />