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PARKER <br /> Environmental Services CHAIN OF CUSTODY FORM <br /> 4185 Rialto Court <br /> �_E <br /> Pittsburg, CA I 94565 Job: <br /> (510) 439-1024 Client: <br /> Fax (510) 439-2566 1 Location: az Date <br /> Sample Type at r. c6 Analysis Requested <br /> Number Soil Water Time TPH BTEX Oil &Grease 8240 Metals {list) Other Remarks <br /> NO 4M A 77 <br /> 2t M <br /> -7 <br /> .......... <br /> V <br /> AS. <br /> MW <br /> TUM, <br /> A WROTE <br /> Sampler Name (Print) I M PAt ec Sampler Signature <br /> 13%A-1 kcNG <br /> By: D <br /> hed B . I Sampling Site Sketch <br /> Relinquished y Date and Time Receiv B ate 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 /> -3 <br /> P-1 <br /> Relinquished By: Date and Time Received By: Date and Time <br />