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F _ <br /> I , r <br /> Chain of Custody Number S�d <br /> SECOR- Chaim-of Custody Record <br /> f <br /> Field Office 077 Sacramento [3 Additional documents are attached,and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Jab Name 7-Eleven Store#32262 <br /> Rancho Cordova,CA Location 2360 West Grant Line Road <br /> Tracy,CA <br /> Protect# 77EI.=262.03 Task# 0410 i Analysis Request <br /> Project Manager Jaff Auchterlonie !� <br /> Laboratory Ktff Analytical � �, <br /> m <br /> Turnaround Time Standard e <br /> �r m V � <br /> r► onm m a uU' 3 034 <br /> Sampler's Name Tom Miller z W 1 m n _ 8 <br /> > <br /> a I- co !C° � oa0 c <br /> Sampler's Signature a m m $ •N m S N 5 m <br /> = a = = e � S m E m g Comments! r <br /> Sample ID Date Time Matrix z F w � m m = m A &1 m Instructions z <br /> MW-1 K x Ix X 3 Q t <br /> MW-2x X X 3 L <br /> MW-3 1 x X X 3 05 <br /> MW-4 ilia x X !' X 3 0y <br /> MW- xX X 3 0'� <br /> MW-6D 517D x X IE X 3 <br /> � P <br /> r 1I <br /> I <br /> Special Instructions/Comments Re d b Received by Sample Receipt <br /> 5 Oxygenates TAME,MtBE,EtBE,TBA, DIPS Sign Sign Total no of containers <br /> Global ID#70607729562(SIRC) Print ,,,,amu �LTur4rA I- Print Chain of custody seals <br /> EDF Deliverables(email EDF to dacatlin@secor corn) Company C ny Redd in good conditron/cold <br /> email lab results to dherzog@secor cam Time Date ime Date Conforms to record <br /> Relinquished by Receiv by <br /> Sign Sign i Client SECOR <br /> Pnnt Print J Client Contact Bnan Caney <br /> Co y Company nt Phone (916)861-Wo <br /> e Date Time CAC Date V0131 10-2, ext 241 <br /> SECM OJSMC fty Z% <br /> Date 57 Page <br />