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{ <br /> PARKER <br /> Environmental Services CHAIN OF CUSTODY FORM <br /> 4185 Rialto Court <br /> Pittsburg, CA 94565 fell • T Cufom e o rn n <br /> (510) 439-1024 Site Name D 5 C 1+25'k-PES <br /> Fax (510) 439-2566 Location: f5 E + � Oct d 7-,-�t t L,, Date <br /> Sample Type Analysis Requested <br /> Number Soll Water Tlme TPH-g TPH-d BTEX 0 & G 8240 Metals (fist) Other Remarks <br /> IV p 2 An.A7 At <br /> �. 21653 :,. . <br /> 1 654 <br /> 13 -5`4, 6. 20 <br /> 740 ✓ ✓ -,.hrn. 21556' �� � <br /> �_7 �g,�a �✓ No. ;21657 <br /> ... . <br /> lNa. . 21659 <br /> GOOD <br /> 4F in am Ai;l AIN <br /> Sampler Name (Print) /r1 P/lqz k esZ Sampler Signature � -- <br /> Relin4sh d By: Date and 11me Received By: Date end T1me Sampling Site Sketch <br /> Relinquished By: Date and Time Received By: Date and Time <br /> Relinquished By: Date and Time Received By: Date and Time <br /> G �a <br /> Relinquished By: Date and Time Received By: Date and Time <br />