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•~ Chain of Custody Number I&W <br /> SECOR Chain-of Custody Record 3 41 IQ <br /> Field Office 077 Sacramento ❑ Additional documents are attached, and are part of this Record <br /> Address 3017 Kilgore Road,Suits 100 _ _ Job Name 7-Eleven Stone#21756 <br /> Rancho Cordova, CA Location 853 East Yosemite Avenue <br /> Manteca,CA <br /> Project# T7EL 21756.03 Task# 0410 alysis Request <br /> Project Manager Jaff Auchterionle <br /> 0 <br /> Laboratory Kiff Anal cal ; e <br /> Turnaround Time Standard 00 <br /> Y 09 Sampler's Name Tom Miller a `� m ° <br /> LD m <br /> Sample's Signature_ - -- E v -S .0 <br /> m o ;N <br /> Sample ID a s = E S' E N Comments/ <br /> p Date Time Matrix = $ x instructions z' <br /> MW-1 /09Z Water X X o f <br /> MW-2 I:L4-b.3 IaJL0 Water X X QZ <br /> MW-3 -/6 *3 /000 Water X X <br /> C3 <br /> MW-4 O(D Water X X y <br /> Y f! <br /> Special Instructions/Comments Relinquished by � ��� Received by Sample Recei t <br /> 5 Oxygenates TAME,MtBE,EtBE,TBA,DIPS Sign 1252 c Sign Total no of oontainers <br /> Global ID#70607700549(SIRC) Print Print Cham of custody seals <br /> EDF Deliverables(entail EDF to inkoch@secor cam) Company Comp Recd in good condibontcold <br /> email lab report to dherzog@secor.com Time 131;4:s- Date 7 p'b T Date Conforms to record <br /> Relinquished byecew by <br /> Sign Sign Client SECOR <br /> Print Print Client ContacL Briar~Caney <br /> Comp Company Client Phone (916)86:1-0400 <br /> T Date Time L.3Q 57- ffiate_D VC5 ext.241 <br /> Date Page /d,- <br />