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PARKER <br /> Environmental Services CHAIN OF CUSTODY FORM ,O'u 9ede- <br /> " 4185 Rialto Court <br /> Pittsburg, CA 94565 job, clients ( -2 TA, C u _ ��n, C2• <br /> (51 d) 439-1024 Site Narne A VFC i-t <br /> Fax (510) 439-2566 Location: l ". 'L«,"t 67V tj K ke'-kj rv- . c Date L - z C -Cl <br /> Semple Type Analysis Requested <br /> Number Soll Water Time TPH-g TPH-d BTEX O & G 8240 Metals (list) Other Remarks <br /> "04 <br /> ,U I ✓ <br /> `f[ i t_�E k1 w, V.0 i9 <br /> _ �ti <br /> l C L41 It tt t i r, .N aN I" E Z►2 r97 .t <br /> . - Cc, .� <br /> . N� -21646 <br /> ` 'an: 21 fi47 <br /> Na 2ts`4R <br /> Awlu d � u; x►, <br /> -1 <br /> s�Ak kw- <br /> No. s 5 0 <br /> Sampler Name (Print) � //h PAC& e2_ Sampler Signature 1N0 2 S51 `+ <br /> Relin shed By: Date and Tlme Receiv By: Date and Time Sampling Site Sketch <br /> Relinqulshed By: Date and Time Received By: Date and Time <br /> Relinqulahed By: Date and Time Received By: Date and lime <br /> �3 tI <br /> Relinquished By: Date and Time Received By: Date and Time !I ~f <br />