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r; <br /> i -_ ,. <br /> BSK Log Number ,_ w <br /> l r, <br /> ANALYSIS E�Et�UESTICHr* 1F Ci1S�bDY I'iEC�}Rgf" t�r �" � r u�n s a��.. <br /> Chant Name ��c' '7 P' -Pc" -" <br /> l�ltll C Ae �fd 5,f iG� civ ! �o�� Lab Use Only <br /> d } <br /> Address. Phone 0 in this . <br /> 475-0 5- c"r ru y��— uuo �i <br /> City,State,Zip Repwl,�ll�n!!� <br /> 5 H ftNA/f�� C.ft10A) — <br /> by <br /> Dale Time _ /tl. f e' tiumf�er EebSears <br /> sampled sampled ='� 1 <br /> h:.auj Sanpla 60=416Md twnts�r (See kW / y D Remarks•sa� - <br /> 1 v: 3U -1 'W/ /09. 5 fr J L Y CL cN <br /> ' <br /> '03 <br /> to:>j <br /> LIJ-'/5 V16 <br /> IMPORTANT NOTICE:No samples will be analyzed WhIlDul an authorized signatetre in This sect on. <br /> 1 am hereby requesting BSK's Nnmtat Ct++drrttlLtwody Procedures for the above sample-c t underslz.'rd the; I am hereby requesting B5K's Forma!Cha"-GWstody Pra.udruzs:for the abr.o samples 1 wWersland Ilial <br /> these procedures we generally cortsitlant wart these out!v>od in the U.S.E.P.A.SW 845 and that Shore is no these Procedures are generally consistent with those oudiued In US EPA Contact Laboratory ftWam Stale- <br /> extra charge lot This servim merit of Work,Suction C and that(hale Is o charge of$5DDO Per-,kx:oder or$500 a botlle.wtkhever is <br /> / greater. <br /> By: LSI -- [�— By: r <br /> Arnhodzed SIg�nre Authorized Siynateto <br /> Sipnahae Print Name Compatry Date Tune <br /> b <br /> RoWn fished b1 <br /> � "4f40A';' C. r;fe— r SA- /�>/t�far <br /> A by Asfcis. <br /> R <br /> z' fl;✓ S P'G67'5-XVn,✓ <br /> Rabnquahea W AcceiVad by <br /> ,y-r <br /> KEY: Type:AO-Aqueous SL- g!W$g1Fbtroleum Or-Qthar I / 4 17 <br /> Seals:P-Present A-Ab„enl B-&oken <br /> SS Chemical Laboralories J /�s DISTRtBUTry WINE,CANARY•1AGORATi]RY PINK-ORIGINATOR <br /> Nae: /4-S Y 11/1,161 ♦c Yj <br /> n / 1414 a r to,California 9JIM6 �,� ! Samples er�'i4 days eller resu1U are reported lmless dher arrangements ar�gta T�f - <br /> Hazardous wtll be ro tx client of d4owd of a1 Want expense. // 7 <br /> 48 10; Fax(20 405,-j427 <br /> el <br /> one f2..-, rrlllr-,. <br /> r o <br /> t <br />