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+' .,EMC Job # ? (CONFIDENTIAL) AEMC Log # <br /> •�++"*�*• SAMPLE MANAGEMENT RECORD <br /> Generator/Client <br /> AEAMC Project Manager <br /> Job Description <br /> SAMPLING INFORMATION <br /> Sampling Date /L Sampling Collector <br /> Sampling Location <br /> (Provide sketch on back and match sample # with sampling location) <br /> Suspected Toxic Constituents <br /> Field Conditions <br /> 1 , r 70°,-' <br /> Sample Depth/ Time Sampling <br /> Sample # Type Drum# Sampled Method Notes <br /> IC r %ice <br /> -,13 — I1 <br /> (For more than 4 samples, attach a Continuation Sheet) <br /> L LABORATORY ANALYSIS <br /> LaboratorContact/Phone # <br /> Date/Time Samples Delivered JL /7J AEMC P.O. # <br /> Report Due Date "Rush" Authorized by <br /> Analysis Requested Ois <br /> 1 <br /> Send results to AEMC Laboratory, Attention: (2 A <br /> ( 1211 �1 <br /> Sample Retention Instructions <br /> CHAIN OF CUSTODY <br /> Relinquished by (Compan Received by (Company) Date/Time <br /> ) / /��� <br />