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0 <br /> PARKER , <br /> Environmental Services CHAIN OF CUSTODY FORM <br /> 190 East 7th Street _ _ a� P� .140 <br /> Pittsburg, CA 94565Job'-C1lelat 2-� <br /> (510) 439-1024 Site Name --Fax (510) 439-2566 LocationGro,,-' �� Date <br /> Sample Type Analysis Requested <br /> � I <br /> Number Soil, Water Time TPH-g TPH-d BTEX O & G 8240 Metals (list) Asbestos Other Remarks I 56771 r <br /> v �Z.¢S/ <br /> 5_67_Z _� <br /> i I <br /> 56773 <br /> �s��,u�� <br /> _� � 1 .30 � ✓ i --___� <br /> 56775 i <br /> t <br /> 1 <br /> 56776 <br /> I � <br /> 56777 <br /> (',GOA GIS r . . <br /> 13���7AUNUIC <br /> Sampler Name (Print) J IM �'I\eQ Sampler Signature <br /> elinquls ed B D e d Time R ceived Date and Time Sampling Site Sketch <br /> Relinquished By ate and Time Received Date and Time <br /> �a L <br /> �a <br /> Relinquished By bate and Time Received By Date and Time <br /> Relinquished By Date and Time Received By Date and Time <br /> 3 <br />