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i <br /> 6- vJ z� <br /> wwwweee*w 06 -2- 0SAMPLE r.. ,_,:MENT RECORD w e r w o e w w w w Ll <br /> Genera tor/Cl ient <br /> AEMC Project Manager <br /> .lob Description <br /> I SAMPLING INPOP 4ATION <br /> Sampling Date`- b <br /> ' Sampling Collector <br /> -2� <br /> Sampling Location <br /> (Provide sketch on back and match sampleffwith sampling location) <br /> Suspected Toxic Constituents <br /> n Z, <br /> Field Conditions "- <br /> i <br /> Sample Depth/--- ime__......�.._ 5�pling <br /> Sample...#. Type Drumo Sampled Method <br /> Notes ` <br /> L11 Zr <br /> --mere an 9 samples, attach a Continuation Sheet} <br /> . �� LABORATORY ANALYSIS <br /> r o Contact/Phone <br /> Date/Time Samples Delivered <br /> Ar,MC P.O.f <br /> Report Due Date "Rush" Authorized by <br /> Analysis Requested , <br /> E <br /> j <br /> Send results to AEMC Laboratory, Attention: <br /> L2 <br /> Sample Retention Instructions +' <br /> CHAIN OF CUSTODY <br /> Relinquished by (Company) Receiv a b __ i-- -- --- <br /> y (Company) Date/Time <br /> Ire <br /> AMERICAN ENYIRONAiENTAL.,'.;�'AGElyENT CORPORATION <br /> 11855 White Rock Road, Rancho Cordova, CA 9567D ;416} 595-6666 <br /> FORM 20-52 Q <br />