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EMCON ASSOCIATES-Sacramento <br /> . WATER SAMPLING AND ANALYSIS REQUEST FORM <br /> EMCON PROJECT NAME: <br /> ASSOOIATQ' SCHEDULED DATE. <br /> SPECIAL iNSTRUCTIONSICONSIDERATONS: Autho P=n. <br /> Pevlem No. . <br /> Task Code: <br /> Send Results To: <br /> Well Lccyt <br /> CHECK BOX TO AUTHORIZE DATA ENTRY Sas Contact- <br /> Name Phone* <br /> Wei Numner Cawng Casmg Depth to <br /> or Source Diameter Length Water ANALYSES REQUESTED <br /> Idermficmion Inc hest (feet) feet) <br /> • <br /> Laboratory GC Instructions: <br /> NOTE: IT IS VERY IMPORTANT TO INCLUDE A COPY OF PROJECT PROPOS <br /> AND WELL LOCATION MAP OR SKETCH WITH THIS REQUEST. <br /> EMCON <br /> Associates WATER SAMPLING AND ANALYSIS REGUESTFORMA=3 <br />