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• � X4750 � <br /> PARKER <br /> Environmental Services CHAIN OF CUSTODYFORM <br /> 190 East 7th Street 3 <br /> Pittsburg, CA 94565 <br /> (510) 439-1024 Site Name <br /> Fax (510) 439-2566 Location <br /> Type Date <br /> Sample <br /> nalysis Requested <br /> Number Sod Water Time TPH-g TPH-d BTEX 0 & G 8240 Metals (list) Asbestos Other Remarks <br /> ly-�6 S <br /> ' 55975 l <br /> )v-,z X 55976 , <br /> r--'6 /0 For ac=- Zqlff% �� 55977 �r <br /> p4� G U. 55978 <br /> i <br /> tnr i+ <br /> .r7 <br /> ,:',PACE A 3SENT.A ./ <br /> Sampler Name (Print) Any Sampler Signature <br /> ulshed B Date Time ece€ved Date and Time Sampling Site Sketch <br /> D l,�/ <br /> '-- �� <br /> nquished y Dat and Time Re lved4Date and Time Qyv5 <br /> Relinquished By Date and Time Received By Date and Tlme <br /> Relinquished By Date and Time Received By Date and Time ,t— <br />