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__�r r r i r r� r �■rr r _ � r r r I•r r r r � wr <br /> Reporting Information American Environmental Network AEN Page A— of l <br /> I hent t6� sNl� a Toa <br /> q��C My i r,f!N kt rg <br /> Address .� 3440 Vjnc ent Road,Pleasant Hill,CA 94523 REQUEST FOR ANALYSIS 1 CHAIN OF CUSTODY <br /> C1 �a>itp�f a. waif. <br /> l R u h r 1,.i M u r t¢i it,. C- AS- 6 8 3 Phone(5 l0)930-9090 7 �,'r Q <br /> Contact Toe a►H a ,--� _ - FAX(510)930-0256 Lab Job Number 1. <br /> Lab Destination <br /> r Aft Contact I1 9 <br /> I Date Samples Shipped <br /> ! Address Report To Send Invoice To Lab Contact 13r 4 L t Th r Vi <br /> Date Results Required 1117.6 /IT 5-i TAT <br /> y, 2 3 li ,�6 94 Follow+d aft tNq <br /> ►+� $ S A wt L> Date Report Required Ax � � �-- <br /> Q u o t a 31:0 1 9 Client Phone No 3 S 4- 31 PI) - - <br /> Client FAX No 3 574 3 3 <br /> ANALYSIS M 4 II e►t o *� �y1 <br /> Send Report To O or 2 (Circle one) <br /> � � * EtIl`lahoi c.�,,,,,•fs � <br /> Client P O No Client Project I D No n[1+c C ey" e i e r y �� hu t- B%4t'4hot <br /> TOF- <br /> ! Sample Team Member(s) kMY <br /> t M <br /> ttiDiPE <br /> Date/ No Type W� -'L <br /> oa Era E <br /> Lab Client Sample Air Time Sample Pres of of o r K M E <br /> Number Identification Volume Collected Type Cont Cont Comments 1 Hazards <br /> 11113 15 NCL V0 Stgndatd, TAT <br /> 1111113 1600 71 RC L G VO A <br /> e\ - 11114 94S -1 HCL r. VOA <br /> 111111110 -1 MCL C VOA XXbl� <br /> 11114 <br /> 1- c v <br /> - F II 1 3S V o <br /> I <br /> M2- WW- 1 "T c v <br /> I <br /> MZ- WVV- Como 0S 1 tio I comfff tte Sid TAT <br /> M - WW - ')p I <br /> s <br /> ' 'r <br /> !! ;Relinquished by DATE TIME Receive#t7y~' T DATECTIME <br /> (Signature) I( u 9 �__} (Signature) - , �7 /' < <br /> ! Relinquished by DAYE TIME Received by DA E TIME <br /> (Signature) (Signature) <br /> III Relinquished by <br /> DATE TIME Received by DATE TIME <br /> i (Signature) (Signature) <br /> ! Method of Shipment Lab Comments <br /> 1 i `Sample type(Specify) 1)37mm 0 8 pm MCEF 2)25mm 0 8 um MCEF 3)25mm 4 4 Nm polycarb filter <br /> 1 4)PVC filter diam pore size — 5)Charcoal tube 6)Silica qel tube 7)Water 8)Soil 9)Bulk Sample <br />