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1. Client: ES American Environmental Ne W AEN Pago <br /> fAME <br /> � <br /> Address: 3440 Vincent Road,Pleasant Hill,CA 94 <br /> .58�)�MFNTO, _CA 9 5 <br /> 853 -4648 Phone(510)930-9090 REQUEST FOR ANALYSIS 1 CHAIN OF/CUSTODY <br /> Contact: JOHN MARGQWSKI FAX(510)930.0256 Lab Job Number: 4IVf � ��Ca00,5 <br /> All.Contact: Lab Destination: <br /> Date Samples Shipped: <br /> Address Report To: Send Invoice To: Lab Contact: <br /> 2• W STERN GEO—ENGINEERS 3. A Dale Results Required: <br /> STREET SAME <br /> Rate Report Required: <br /> -- <br /> _j1annT.ANDS rA 776-611n-1 Client Phone No.: <br /> ClientFAX <br /> Send Report To: 1 or 2 (Circle one) ANALYSIS <br /> Client P.O.No.- Client Project I.D.No.: <br /> Sample Team Member(s) O t t E r C/ `►j�W 1 <br /> Lab Client Sample Air Date/ Sample No. Type <br /> Number Identificalion Volume Time T e. Pres. of of <br /> YP C <br /> Collected T Conl. Cont, i� Comments/Hazards <br /> 1A6 2: 3 7 7 ly cG 2 1404.� <br /> b Mw-Z 1: 17 <br /> Mw - 3 r;L { <br /> s S 12 05 — — <br /> b G 0; y3 — — <br /> 7 !; S <br /> — <br /> /Ok.,IV 9 0q <br /> w - 10 1 : qq <br /> n•w - 11 L: y9 — <br /> p. MW_ rZ : 30 <br /> z: IS — <br /> Relinquish; by: 7 TIME Received by- DTE TIME <br /> (Signature} j 1 �`O� (Signature} ' / 2. � <br /> Re <br /> Relinquished by. A TIME, � DATE TIME <br />(Signature) / j 'S gnalure <br /> Relinquished by: DATE TIM Received DATE TIME <br />{Signature) (Signature) <br /> Method of Shipment Lab Comments <br /> 'Sample type(Specify): 1)37mm 0.8 irm MCEF 2)25mm 0.8 um MCEF 3)25mm 0.4 pm polycarb.filter <br /> 4)PVC filler, diam, pore size 5)Charcoal lube 6)Silica get tube S)Water 8)Soil 9)Bulk Sample <br /> 10)Other 11)Other <br /> COPIES: WItlTE-JOe FILE YELLOW-PROJECT FILE PINK•CLILNT <br />