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,ep ringlntormation: American Environmental MW A AE Pago of <br /> I. WICKL RD PROPERTIES �. <br /> 3440 Vincent Road.Pleasant Hill.CA 93523 REQUEST FOA ANALYSIS 1 CHAIN OF CUSTODY <br /> Address 3 4 6 4 8 Fhont(S 10)930-9M �j� 5-71 Z ( p!j <br /> FAX(510)930-02560 3S� Lab Job Number: <br /> Contact Y Lab Destinattoa: <br /> A6.Cwtaq; Date Samptes Shipped: <br /> Send Invoice Ta: Lab Contact <br /> ild&m RepWTa: Dale Results Aet uhed: <br />'2 Tsi SxERK GEO—ENGIN1~ERS 3. Do.toRepadRequired_ <br /> t31 M E S T £>r _ Client Phone No., <br /> Client FAX No <br /> ANALYSIS <br /> cSead Report To: 1 or 2 (Circle oae) <br /> Cum PaNo.: Client Project I.Q. <br /> Sanspte Team Member(S) <br /> Cartel No.� Type <br /> FMLab Client Sample Air Trw Satnpe Cl cl of Comrnentsf Hazards <br /> Idenlilicali3n Volume Calected Tyke Cont. Cont. <br /> r,t 7 Mex, 7 <br /> 1}tfC <br /> DTIME Rtxeived by: DA-1AIS I/MEC_ <br /> Relinquished by: , t `" /5 <br /> r� !�, (Signaturol DATE <br /> CATE 711�tE Reeelveci by: <br /> Relinquished by: C" f , /` �/ (Signature) —2--17 <br /> j.Sisnatwre) C l.� �� DATE TIME= <br /> #teAngwished by DATE TIME deceive aby: <br /> (slgrulure) 11.9b Comments <br /> llde4lsod al Sttipnnenl <br /> 'Sarnpla tjpa(SpecE'r): 1)37mm0.8 pm MCEF 2)25mrn 0.8 un MCEF 3)25mm 0.4 ym polycarb.Triter <br /> 4)1'VC liter. diam. pare size 5)Charcoal tube 6)Silica gel tube 7)Water 8)Soit 9)StAk Sample <br /> 10)Dther t 1)Other <br /> COPES. WHITE•JOBFILE YRL04Y•P=CrF1LE PSIK•CLUT <br />