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r� L <br /> SAMPLE A. ,,t.MNT RECORD (' L� <br /> Generator/Client <br /> AEMC Project Manager <br /> Job Description -7 /A/ <br /> / SAMPLING INFORMATION <br /> Sampling Date 6"� �garflpling Collector <br /> Sampling Location <br /> {Provide sketch on hack and match sample with sampling location) <br /> Suspected Toxic Constituents <br /> G > r 2 <br /> Field Conditions •G '� <br /> Sample Depth .-Time-- E <br /> sample. T Sampling Type Dr-- Dsum# Sampled Method - <br /> Notes_ <br /> Al P <br /> -r�iE- 3 ' ,• 1, � n <br /> —more an 4 samples, attach a Centanuation Sheet) <br /> LABORATORY ANALYSIS <br /> f <br /> 4 Contact/Phone <br /> Date/Time Samples Delivered �j12 2/ (o <br /> AEMC P.O. � <br /> Report Due Date "Rush" Authorized by <br /> Analysis Requested <br /> Sand results to AEMC Laboratory, Attentions_ 'f <br /> Sample Retention Instructions <br /> CHAIN OF CUSTODY <br /> Relinqu.ished_.by___(Company)------Receiv d--by- {Com anDate/Time ----- - <br /> --- --------- - �� p y) -- ---------------- - <br /> AMERICAN ENVIRONMENTAL a?,:NAGEMENT CORPORATION <br /> 11855 White Rack Road, Rancho Cordova, CA 95670 (916) 985-6666 <br /> FORM 20-52 <br /> . `v <br /> Milan 11 <br />