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v e 11 -7� <br /> Chain-of C.4-todv Number <br /> SECOR Chain-of Custody Record <br /> Field Office <br /> Additional documents are attached, and are a part of this RArd <br /> v� � � <br /> Address 3oll L4 L 5rn1C SIJ w Job Name Al L <br /> L L� C YL 0 otl,) C 9 S "11 Location <br /> T � <br /> Project#6211-117 3� OU'LTask#�S Analysis Request <br /> Project Mana er�o-:,',-' 32LNOIJ �- <br /> Laboratory kVLL L G L,(-� -- y <br /> k <br /> U <br /> Turnaround Time <br /> Ov ro o <br /> Sw <br /> .20 <br /> 0 <br /> Sampler's Name '\ ao Cm on ° <br /> H -�2 <br /> o yo a)po m h <br /> E m 06 >, N 0J <br /> =_ m coSampler's Signature co a C - <br /> Comments/ <br /> Wco <n(D aW n a2 <br /> ZSam le ID Date Time Matnx o � Instructions w° <br /> 'uFors K IA l l D 0 v <br /> Special Instructions/Comments Relin s ed Received b 04. Sample Receipt <br /> Sign Sign Z Total no of containers <br /> Print Print CiY5764, r,614WAP7Z Chain of custody seals <br /> Company .SCtUll, - -- _ Company "MUO l Rec'd in good condition/cold <br /> Time s Date "�-V TimB %-k Date Conforms to record <br /> Relinquished by Received by Client 2-rUl( <br /> Sign Sign <br /> Print Print Client Contact /D <br /> Company Company /_G W <br /> Time Date Time Date Client Phone <br /> SECOR CUSTREC Rar 2/88 <br /> Date � � � I � w Page L of <br />