Laserfiche WebLink
Cham of Custody Number 4& p <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento 0 Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road,Suite 100 Job Name 7-Eleven Store#17334 <br /> Rancho Cordova,CA Location 4501 North Pershing Avenue <br /> Stockton,CA <br /> Project# 77EL.17334.05 Task# 0410 Analysis Request <br /> Project Manager Damon Brown <br /> Laboratory Kiff Analytical 2 W <br /> Turnaround Time Standard a <br /> LU 6 — a � Q � O _ <br /> Sampler's Name Co e «I -6 m 0 1 Q <br /> � .9 am <br /> umi t- a m n0 �°0 1p0 Wo mm 0 <br /> Sampler's Signature 2 £ .19 m % m <br /> Q <br /> y o a 9 v S'd oW E? n x a Comments) e <br /> U a ao a o on � o asci Od <br /> Sample ID Date Time Matrix z „ r m > w I a Instructions z <br /> MW-2 Water x X X 3 <br /> MW-3 Water x X X 3 <br /> MW-4 lZ � Water x X X 1 3 -D <br /> MW-5A Water x X X 3 <br /> MW-513 Water x X X 3 <br /> Special Instructions/Comments Relinqui y 4 O/ Received by Sample Receipt <br /> 5 Oxygenates:TAME, MtBE, EtBE,TBA, DIPE Sign Sign Total no of containers <br /> �: <br /> Global ID#T0607700407(SIRC) Print Print Chain of custody seats <br /> email EDD to cryan@secor.com Company Company Recd in good condition/cold <br /> email results to dherzog@secor.com secor.com and Time Date to(W(or Time Date Conforms to record <br /> dbrown@secor com R lanquished by Received y <br /> °� TIMM l00-�- Sign _ Sign � Client SECOR <br /> 7e�^¢spate to Print Print r! Client Contact Damon Brown <br /> lnttht �pltM� ° Y N Company Company Client Phone 916 861-0400 <br /> Tte3Time Date ime Date f v ext. 230 <br /> SECOR CUSTRE-C fkd�2A9 <br /> Date � ?�� oS Page p � <br />