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o�90OD/7 FlUb" . 00 <br /> PARKER E <br /> Environmental Services CHAIN OF CUSTODY FORM � <br /> b <br /> P. O.. Box 8867 <br /> Pittsburg, GA 84565 i �-''F��� CITY OF LODI m <br /> m <br /> (925) 519-7782 OAPO RATION YARD m <br /> Fax (925) 473-0784 Location: 1331 SOUTH HAM STREET LODI, CA Date AUGUST 1, 2002 S <br /> Sample Type Analysls Requested o <br /> Number Soil Water Time TPH-g TPH-d BTEX 0 G MTBE Metals(list) Asbestos Other Remarks I z <br /> ID <br /> � C <br /> m <br /> cn <br /> m <br /> i D <br /> z <br /> 0 <br /> � N <br /> I <br /> A <br /> U <br /> co <br /> La <br /> Sampler Name(Print) �J (ml �41k k It Sampfer Signature <br /> m <br /> m <br /> li shed By ate and Time rve B : ate and Time Sampling Site etch <br /> �2, s? vi`ljbU2 2131 <br /> m <br /> ,17R <br /> elinqulshed . Date and Time Received By: Date and Time N <br /> Relinquished By: Date and Time Received By: Date and Time —f—D c3$ T-S In <br /> 3 <br /> Relinquished By: Date and Time Received By: Date and Time <br /> -- ._-- <br />