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NMA Uniwnoi 3050 Industrial Blvd. ^_'�7 <br /> !enginaodng V West Sacramento,CA 95691 <br /> UI-1"" 916.372.1434 Lab No. ` Page 1of <br /> 1, ComP°w Fax:916.372.2565 <br /> WKA Carbon Copy addresses Dyes ❑No Chain-of-Custody Record and Analysis Request <br /> irosenbery at7.wallace-kuhl.com California EDF Report? Project Manager(Hardcopy or PDF To): Dennis Nakamoto <br /> dnakamoto(a)wallace-kuhl.com WKA Email Address: dnakamoto@wallace-kuhl.com <br /> Company/Address: Recommended but not mandatory to complete this section: Analysis of Request Q <br /> Sampling Company Log Code: H <br /> see above 1�Hr <br /> Phone No.: Fax No.: Global ID: <br /> see above see above 24 Hr <br /> Project Number: P.O.No.: EDF Deliverable To(Email Address): O 21 <br /> c <br /> 13221.02 48Hr O <br /> Project Name: Sampler w <br /> Westlake Villages E,G,H,I,J Signature: o 76r <br /> Project Address: barnpling on alner Preservative at rlX <br /> m <br /> a <br /> r2W <br /> KWSample K-� E E c-� = pC <br /> Desi nation ° ° o o " " W Q <br /> Date Time v to N = z = _ 2 to o <br /> �6 SSA .A <br /> C�. <br /> 'OA <br /> Relinquis Date Time Received by: Remarks: <br /> please send copy of report to jcoburn@wallace-kuhl.com <br /> Relin i e Date Time Received by: <br /> Relinquished by: Date Time Received by Laboratory: Bill to:Wallace-Kuhl&Associates c/o <br /> //,/'I WKA Contact and swilliams@wallace-kuhl.com <br /> 5 <br />