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LAItContact <br /> q�DU J-(=fw 3440 Vincent Road,Pleasant fI 94523 <br /> D � Phone(510)930-909 REQUEST FOR ANALYSIS/GOOF CUSTODY <br /> FAX(510)930-0256 Lab Job Number 70 <br /> R Lab Destination <br /> E C El DEQ y <br /> 1Ay 1 2 1997 Date Samples Shipped <br /> Address Report To Send invoice To Lab Contact <br /> Z ( = 1��j� ' � t g L fJ Dale Results Required <br /> 2 0 711 ,f l) -r— 0 _ Date Report Required <br /> _d , 1A NIP CY± q L�6[,�" Client Phone No <br /> Client FAX No <br /> Send Report To 1 or 2 (Circle one) ANALYSIS <br /> ( 11'ent P O No Client Project I D No FQ <br /> Sample Team Member(s) <br /> Lab Client Sample \'Air Date/ Sample No Type hV <br /> Number Identification Vo6me Time GCollected Type` Pres Coof of <br /> nt Cont �~ <br /> Comments/Hazards <br /> z A8c ^ Z <br /> 0-3 8C M w —'3 <br /> I � <br /> YA W — 0- <br /> M Li O <br /> E <br /> r,7 <br /> fl c k1w - 7llfl{d <br /> 0$64C ltd�w <br /> Relinquished by DATE TI <br /> (Signature) 7.fir�, i� .� Received by rf D�;TE �,/ TIM <br /> �-' � = "� l ��� (Signature) r j'( —! � �J " Cl <br /> Relinquished by DA E Received b <br /> (Signature) TIMDATE VE <br /> -3 y �-� (Signature)y � Y--Z3-97 <br /> Relinquished by DATE TIME Received y DATE TIME <br /> (Signature) (Signature) <br /> Method of Shipment Lab Comments <br /> I <br /> Y <br /> "Sample type(Specify) 1)37mm 0 8 um MCEF 2)25mm 0 8 prn MCEF 3)25mm 0 4 dim polycarb filter <br /> 4)PVC filter, diam pore size 5)Charcoal tube 6)Silica gel tube 7)Wator 8)Sod 9)Bulk Samplo <br /> 10)Other 11)Other <br /> COPIES WRTE JOB F ILE W I OW PROJECT RLE PINK Cl IENT <br />