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AEMC Job # 4�- VOF( (CONFIDENTIAL) J—?MC Log <br /> ********* SAMPLE MANAGEMENT RECORD ********** <br /> Generator/Client � Al <br /> AEMC Project Manager_ <br /> Job Description C 0 G �1;71Z /9 S" 7` A✓�lr <br /> SAMPLING INFORMATION <br /> Sampling Date _S �' (61 Sampling Collector <br /> Sampling Location <br /> (Provide sketch on back and match SEFp-17T with sampling location <br /> Suspected Toxic Constituents L N 4--i <br /> Field Conditions lk , �ti C f <br /> Sample Depth/ Time Sampling <br /> Sample # Type Drum# Sampled Method Notes <br /> 57 /7 <br /> (For more than 4 samples , attach a Continuation Sheet) <br /> LABORATORY ANALYSIS / / <br /> Laboratory - 14 i e ���, Contact/Phone # �4 7 P v� <br /> Date/Time Samples Delivered : y:%moi EMC P.O. # <br /> Report Due Date "Rush" Authorized by <br /> Analysis Requei '1-6;Z1- <br /> 0 <br /> �d i^ / � C_� � / 6j '„l0 <br /> Send results to AEMC Laboratory, Attention: <br /> Sample Retention Instructions <br /> CHAIN OF CUSTODY <br /> Rel 'nquished by (Company) Re eived by (Company) Date/Time <br /> ESC /V-/�" �6 -- /.qd <br /> AMERICAN ENVIRONMENTAL MANAGEMENT CORPORATION <br /> 11855 White Rock Road, Rancho Cordova, CA 95670 (916) 985-6666 <br /> FORM 20-52 <br />