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PARKER <br /> Environmental Services CHAIN OF CUSTODY FORM <br /> 4185 Rialto Court <br /> Pittsburg, CA 94565 Job, Client, ! -2 (- T 1\4 C k tL a v- Cc, <br /> (510) 439-1024 Site Na_M e ) <br /> Fax (510) 439-2566 Location. 1 «�f �� �, — Date L - L C <br /> sample Type Analysis Requested <br /> Number Soil Water Time TPH-g TPH-d BTEX 0 & G 8240 Metals (11st) Other Remarks <br /> w - � <br /> a- iart Y� {t t r L W f CSM r s <br /> 4 <br /> f <br /> 21646 <br /> 216 47 <br /> Na 2.1648 <br /> o s LP i� uati, All 2X 649Gil 00 <br /> An SP � 1650 , <br /> _�.._. 'No.,,-2i <br /> fy <br /> ,7 1/h pActe-�- PSignatureN0. 2 f s5 <br /> Sam ler r s� _ <br /> Sampler Name (Print) <br /> RelinqV49hed By. Date and Time Rewlygo By. Date and Time Sampling Sit- <br /> E, <br /> ite; <br /> Relinquished By. Date and Time Received By Date and Time 6,-w4t <br /> j, i <br /> Relinquished By. Date end Time Received By. Date and Time <br /> 403 <br /> �. r1 <br /> Relinquished By Date and Tlme Received By Date and Mme . <br />