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Chain-of Custody Number <br /> E <br /> SECOR Chain-of Custody Record <br /> Field Office U'rI CIC r-a",k+O Additional documents are attached, and are a part of this Record <br /> Address 3011 . o fe ea }e too 11 II, Job Name kct oc.1� ACL#- <br /> I <br /> Ra+RC6 Cor6wx, C-A470II II Location 2-3S01 S, &vt K4qk l= <br /> ,I II River6tky., <br /> Pralect# 0.71 UO-002+ Task# �' �I IE Analysis R est <br /> Project Marta er_j A o1,1-er(oxi L <br /> Laboratory4 a1 ticalQ1a <br /> tA <br /> Turnaround Time 10 At k H N 9 �.. g, Wo <br /> C m "2 � <br /> cid �U �� pc°0i a ' <br /> Sampler's Name r-1 a it GSI ^e tal$ W G o p o iso o <br /> Samplers Signature. 10 m <br /> m N �� > 4_ o L <br /> Sample ID Clate Time fJlatnx z m z c a c r° a 2 "�a 23 Comments/ <br /> Efl Instructions z <br /> - z (31.5 Soxvc Soxdws— TME MtBE v l <br /> i �fiBE T a <br /> - <br /> I <br /> Special Instructions/Comments `, Relin' h'e by *r Cate Received by Sample Receipt <br /> ,quisjD F G b bat Mb Mu W leerp�n{� RE. <br /> •• Sign Total no of containers <br /> 4 Print <br /> Chain of custody seals <br /> TD 60-110 0 `1 1 7 Company t Sf-COM Company <br /> Time'IS-35 Date I�-S-o f Time Date Recd in good condition/cold <br /> ' Conforms to record <br /> Relinquishy ied by F Received b IL <br /> Sign Sign Client ��Co <br /> Print'[ Il Pnnt - Client Contact TAWAwW& <br /> Company J! Company <br /> Time`I �I Date Time Date Client Phone 110 $�ct-ofoa <br /> SECOR CVSTFW Rw 2M ` <br /> , <br /> Date C) Page of <br />