Laserfiche WebLink
• Chain of Custody Number <br /> SECOR Chain-of Custody Record <br /> Field Office 077 Sacramento D Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road, Suite 100 _ Job Name 7-Eleven Store#21756 <br /> Rancho Cordova, CA Location 853 East Yosemite Avenue <br /> Manteca, CA <br /> Project# 77EL 21756 03 Task# 0410 Analysis Request <br /> Project Manager Jaff Auchterlonie o <br /> Laboratory _Kiff Analytical _ co <br /> co <br /> 8 <br /> Turnaround Time Standarda �, ro <br /> iu r_ a a)0 :3 v o <br /> 11 0 <br /> Sampler's Name Tom Miller w o '� °7 0m <br /> Sampler's Signature m E °' " N m o l <br /> — _ � � v m � - � o,� ? 00 Tao <br /> E o – E x a Comments/ <br /> Sample 1D Date Time Matrix z 1 w � � � M (0 rn n ° w Instructions z <br /> Mw-1 -7-/6-°33 /o V6 Water X X b) <br /> MW-2 d-bg laaO Water X X SF oe <br /> MW-3 -/6 of /004 Water X X rt (`j3 <br /> MW-4 00 Water X X <br /> Special Instructions/Comments Relinquished by 7—,a d25 c Received by Sample Receipt <br /> 5 Oxygenates TAME, MtBE, EtBE,TBA, DIPS Sign Sign Total no of containers <br /> Global ID#70607700549(SIRC) Print �e � Print Chain of custody seals <br /> EDF Deliverables(email EDF to mkoch@secor com) Company �$'�c Comp° Recd in good condition/cold <br /> email lab report to dherzog@secor com Time31 �jS-Date -7 I u3 Ti Date Conforms to record <br /> Relinquished by rlkeceiveckby. <br /> SignSign IkIl T4 OrClient SECOR <br /> Print Print Client Contact Brian Carey <br /> Comp Company Client Phone 916 861-0400 <br /> Ti Date Time41 to 7 ext 241 <br /> SEGPR CUSTREC Rev 2198 <br /> Date ,� Page /d,G <br />