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FsPECIAL <br /> EMCON ASSOCIATES-Sacramento <br /> WATER SAMPLING AND ANALYSIS REQUEST FORM <br /> PROJECT NAME: <br /> s SCHEDULED DATE: <br /> Protlect <br /> INSTRUCTIONSICONSIDERATONS: Authorization: <br />' Project No. <br /> Task Code: <br /> Send Results To: <br /> Well Lock <br /> t <br /> CHECK BOX TO AUTHORIZE DATA ENTRY Site Contact: <br />' Name Phone# <br /> Well Number Casing Casing Depth to <br /> or Source Diameter Length Water ANALYSES REQUESTED <br />' Identification inches feet feet <br /> 1 <br /> Laboratory QC Instructions: <br /> ' NOTE: IT IS VERY IMPORTANT TO INCLUDE A COPY OF PROJECT PROPOSAL <br /> AND WELL LOCATION MAP OR SKETCH WITH THIS REQUEST. <br /> EMCOIV FIGURE <br /> Associates <br /> WATER SAMPLING AND ANALYSIS REQUEST FORM C=4 <br />