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t <br /> PARKER <br /> Environmental Services CHAIN OF CUSTODY FORM <br /> 4185 Rialto Court <br /> Pittsburg, CA 94565 Z 16 <br /> (510) 439-1024 <br /> Fax (510) 439-2566 Location / cup C� cL-w Z Tj- v Date <br /> Z <br /> Sample Type Analysis Requested <br /> Number Sall Weser Time TPH-g- BTBX Oil &Grease 8240 Metals Qlst) Other Remarks <br /> IL}- k r/ 4,5b r/ Sauk <br /> Vol /M5, <br /> �r <br /> Sampler Name (Print) J'r m P Ic Sampler Signature <br /> Zn!q[F� ru By Date and Time Receiv y Date and Time Sampling Site Sketch <br /> -2 2 Z 9 ,C) t y=tz 4L P o <br /> Relinquished By. Date and Time R ved By. Date and Time <br /> Relinquished By Date and Time Received By Date and Time <br /> Relinquished By Date and Time Received By Date and Time <br /> t <br />