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PARKER <br /> Environmental Services CHAIN OF CUSTODY FORM <br /> 4185 Rialto Court <br /> Pittsburg, CA 94565 11x6 71-e <br /> Cu ►�, amn <br /> (510) 439-1024 Site NaMe 16 V C (-ke pi~ <br /> Fax (510) 439-2566 Location: (5 .+ � oa ,,u Date 2-z 4 r 93 <br /> Sample Type Analysis Requested <br /> Number Soil Water Time TPH-g TPH-d BTEX O & G 8240 Metals (fist) Other Remarks <br /> 2✓+�A 7 t4 IL-7 �/ v Nn: ,21652 <br /> o. 654 <br /> c� .h0._ <br /> r No. 21657 <br /> Na. =21658 <br /> Its'° ✓ ��._,�.__�_:;. <br /> W in t!w <br /> Sampler Name (Print) m PAw lc Sampler Signature j, - <br /> Relin0y1sh d By: Date and Time Received By: Date and 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 /> L �G <br /> Relinquished By: Date and Tlme Received By: Date and Time <br /> k <br />