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PARKER <br /> Environmental Services CHAIN OF CUSTODY FORM <br /> P. O. Box 8067 - ----- - --- <br /> Pittsburg, CA 94565Job <br /> iient_'..2-4-6 - - <br /> (925) 519-7782 V7,f <br /> - ---- <br /> Fax (925) 473-0784 Location: � - D8f@ ! O'.� — <br /> Sample Type Analysis Requested <br /> Number Soil Water Time TPH-g TPH-d BTEX O&G MTBE Metals(list) Asbestos Other Remarks6RjV1_jk L7 W7 <br /> -_ - <br /> 0 <br /> XL <br /> 36 <br /> 8 <br /> 8545X ) 89545- <br /> Y\ <br /> Z tet. 'X 2-.00 89547 <br /> Sampler Name(print) T,•P\ ai,rk- _ Sampler Signature )Sketcl eel <br /> el i By: to and Time ece�ved By. Date and Time Sampling S <br /> L/a it 3:a L -4 4r�' i -12- <br /> Relinquished <br /> 2- <br /> Relinquished By: Date and Time Received By: Date and Tine <br /> Relinquished7Dateme Received By: Date and Time PffME M(INHEAD SPACE ACRI T � `'FnIATERelinquishedme Received By: Date and Time —•«O+ITAi�\EPiS <br />