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Reporting Information <br /> American Dim ownenta! Netwo►k AEN <br /> 1. Client _W�CKLAND PROPERTIES Page of <br /> Address P.Q. Box 13648 3440 Vincent Roid,Pieasant}lilt,CA 94523 REQUEST FOR ANALYSIS 1 CHAIN OF CUSTODY <br /> �aacramento QA 95853-46 8 Nw ie(9 10)930-9090 [y n q <br /> Contact John Mar owski I AX(510)930 02% Lab Job Number t �V 1 361 <br /> 1 <br /> All Contact Lab Destination <br /> Date Samples Shipped <br /> Address Report To Send Invoice To Lab Contact <br /> 2 Western Geo-Engineers 3 Date Results Required <br /> Same As #1 Date Report Required <br /> 13136 E. Beamer Street Client Phone No <br /> Woodland, CA 95776-6003 Client FAX Noe <br /> Send Report To 1 or(D(Circle one) <br /> ANALYSIS <br /> Client P O No Client Prolecl IP No RA20LI <br /> Sample Team Member(s) <br /> Lab Client Sample Air nate/ Sample No Type <br /> Number Indenllftcalion Volume Time Type. Pres of o r <br /> Collected Cont Coni Comments/Hazards <br /> j4Vt 014 tr7, <br /> w- 3 120f -�, <br /> As LCi— 1;.7 z <br /> 5 t+v-- .L <br /> 2-1 Wr Z 4 LTU <br /> ►e <br /> Relinquished by <br /> "JIDYE/ TIME: Received by / TAME <br /> (Signature) (Signature) � i _ Q <br /> A TI <br /> Rb <br /> (Signature)Relinquished by Received DATE TIME <br /> � <br /> (Signature) r _r Z-r f{ [& 3<: <br /> Relinquished by DATE TIME Received by DATE TIME <br /> (Signature) (Signature) <br /> Method of Shipment Lab Comments <br /> 'Sample type(Specify) 1)37mm 0 8 pm MCEF 2)25mm 0 8}gym MCEF 3)25mm 0 4 pm polycarb tiller <br /> 4}PVC tiller, dram pore size 5)Charcoal tube 6)Silica gel tube 7)Water 8)Soil 9}Bulk Sample <br /> �• 10)Other __YE Other <br /> COPIES wI+rTE JOB FILE ROJECT FILE PINK CLIENT <br />