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Page r Of i <br /> Laboratory Information Original Copy of Report Sent To: Special Instructicins: <br /> Laboratory Soil Control Lab Company: Forward-Republic-Services- <br /> Address: <br /> orward-RepublicServicesAddress: 42 Hangar Way:Watsonville,CA 95076 CorTtact: Kyle Maciel <br /> Phone:{83,1}724-5422 Fax:{831)724-3188 Addressi: 9999 S-Austin Road <br /> Person from your company to be contacted with questions Address2 Other Analyses Requested <br /> Name: Kyle Maciel 4'r <br /> Y City,St-zip Manteca Ca 95336 = <br /> Phone#s: <br /> 2039 423-2407 <br /> t ) Phone: 2099824298 Fax: n <br /> Information on facility that the sample was drawn from E-mail Reports To: in box below fill in to 3 address f, • A `. <br /> Po S P } � rt <br /> Company: Forward Republic Services kmaciel([r�.repuhllcsarvices,cpm '= <br /> - m <br /> v <br /> Contact: 2=5.. <br /> Kyle Maciel ccarbaiall5r, ublicservices.cpm <br /> Addrewl: 9999 S.Austin Road <br /> Invoice Sent To: N h <br /> Address2 Z, pCompany: Republic Services <br /> City,St Zip Manteca Ca 95336 Contact Q <br /> Christina Carbajal m <br /> E-mail Addr. e <br /> Addressl: 9999 S. Austin Road aD <br /> Phone: City.St-Z-1P: Manteca Ca 95336 t o <br /> Sampler'sPrinted Name: 30589950 0 (U <br /> Kyle Maciel PO#: _ <br /> N <br /> Sample <br /> P Date&—Rme Complete Compost Pkg ;' <br /> Identification 0D tie• ^ <br /> Sampled STA No STA c U <br /> Super Compost ra,I_ z �i,ci X <br /> X X X �_:: <br /> .T of <br /> - <br /> 'Optional.Help us in our.research. Please list your feedstock and approximate%used,process,and age of material. Thank you. <br /> Manure type&% Biosolids% MSW% yard waste% Foodwaste Industrial type&% Other type&% Comp-Process Age of material <br /> Sample 1 <br /> Sample 2 <br /> Sample 3 x <br /> Sample 4 <br /> Sample 5 <br /> Released B (Signature and Printed Narne): Date[Time: Received B (S and Printed Name): Datemme: <br /> Kyle Maciel .� i . <br /> -r Z 3 <br />