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AEMC Job # Z (CONFIDENTIAL) k AC Log # <br /> **t****** SAMPLE MANAGEMENT RECORD *****:***• <br /> Generator/Client � )CJS " ✓c <br /> AEMC Project Manager <br /> Job Description <br /> SAMPLING INFORMATION <br /> Sampling Date 4t, - E ' 7 Sampling Collector rrinyk 6 cy rn '� <br /> Sampling Location <br /> (Provide sketch on back and match sample # with sampling location) <br /> Suspected Toxic Constituents f4 T c <br /> Field Conditions <br /> Sample Depth/ Time Sampling <br /> Sample # Type Drum# Sampled Method Notes <br /> I8 <br /> (For more than 4 samples , attach a Continuation Sheet) <br /> r LABORATORY ANALYSIS <br /> Laboratoryea.%a Contact/Phone # <br /> 0- ' -46103 6 <br /> Date/Time Samples Delivered `�' ii . .. AEMC P.O. # <br /> Report Due Date ✓S "Rush" Authorized by �eGnf3 <br /> Analysis Requested ✓ ��X UZU a.�� ��S m odd <br /> C PC�7rC/ GSD L` IS/ <br /> Send results to AEMC Laboratory, Attention: <br /> Sample Retention Instructions <br /> CHAIN OF CUSTODY <br /> Relis d by (Company) Received by (Company) Date/Time }i <br /> �z <br /> AMERI&N ENVIRONMENTAL MANAGEMENT CORPORATION _ <br /> 11855 White Rock Road, Rancho Cordova, CA 95670 (916) 985-6666 <br />