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L)15TFZ ENGINEERING AND CON5TRUCTION, I.NC- GAIN OF CUSTODY / <br /> Tvanemit:reseilte to of lee ebecked belowt REQUEST FOR ANALYSIS <br /> 33233 South Koster Road,Tracy, CA 95304 �C� RECORD <br /> Voice: (209)8324910 Fut; (209)833.1288 -. <br /> ❑ 1120 Hollywood Aver-No 3, 091dand, CA 94602 Laboratory, <br /> Voice(510)336.9118 Fax; (5 10)336-9119 Carders <br /> Prpjeot; .� Waybill No.: <br /> Projeot No,: __—�r Got Mgr, ,�•�t" 2 y a 2 Z,,a <br /> Sampling Tetam, <br /> Me Global I.D. No,; <br /> ' nnlysos Requested <br /> 8nmple Type NOW 'W0111jend/ Dqo to Date The A <br /> Nl Lair No. <br /> Number palgt &u'6 Blov. G9V/Baatplo Sampled anmplod <br /> C7 2 r 5Q e� <br /> prlorlty, Roullne,r &tpedfled 0 Speolal 0 <br /> Bampla Hazards; <br /> Notes; fib•• .� <br /> CU RI�CIaRD Print Name C an Date Reoelved Time Reoelved Date Rel ulslusd Time Relinquished 81 nature <br /> l ; <br /> Received/Relinqulshedby: <br /> Reoelved/ItelinclWeW by: <br /> Reoewad/Relinquishes!by: <br /> Renewed at Lnbaratory by: tGi.0/0 <br />