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EMCON-SACRAMENTO <br /> GROUNDWATER SAMPLING AND ANALYSIS REQUEST FORM <br /> PROJECT NAME Don Rodgers,515 West Charter Way,Stockton <br /> 1 <br /> SCHEDULED DATE March 3,1998 <br /> Protect <br /> SPECIAL INSTRUCTIONS/CONSIDERATIONS : Authorization Deanna Santos <br /> 1st Quarter 1998 Groundwater Monitoring Event EMCON Prof # 22613.100 001 <br /> OWT Prof # 70099 <br /> Task Code <br /> Nlenitering date is eeordinated with A -2!68(&Blame)- Originals to D.Santos <br /> To be coordinated with IBC-Stockton and Arco 2168; cc <br /> These sites were already completed in February. Don Rodgers has <br /> been on hold since 3rd Qtr 97'. <br /> � �,/ Well Lock <br /> 751p.., z., —t7'27�/Yl Gv/� E'(lQ/� 74U Number(s) <br /> CHECK BOX TO AUTHORIZE DATA ENTRY Site Contact <br /> Name Phone# <br /> Weil Number Casing Casing Depth to <br /> or Source Diameter Length Water ANALYSES REQUESTED <br /> (inches) (feet) (feet) <br /> 2124197 <br /> MW-IR 40 519 2268 T BE/BTE 1518020) <br /> p (8020) <br /> E�c�es b� goo <br /> (Tle0 t evc� k ukl�nd j <br /> C _ <br /> 1 <br /> Laboratory and Lab QC Instructions <br /> Sequoia Analytical <br /> 819 Striker Avenue,Ste 8 <br /> Sacramento,Ca 95834 <br /> 916-921-9600 <br /> Page 1 of 1 <br /> � R <br />