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3050 Industrial Blvd. <br /> NM au"tVefO' West Sacramento,CA 95691 <br /> Engineering <br /> S""-,S""-, Tel:916.372.1434 Lab No. 'v//7 <br /> 1 Page 1z of,L <br /> W�11BCP "' c°ma 'Y Fax 916.372.2565 <br /> WKA Carbon Copy addresses Dyes []NO Chain-of-Custody Record and Analysis Request <br /> irosenbery anwallace-kuhl.com California EDF Report? Project Manager(Hardcopy or PDF To): Dennis Nakamoto <br /> dnakamotona 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: N <br /> see above 18Hr <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 <br /> c <br /> 13221.02 48Hr o <br /> Project Name: Sampler v° <br /> Westlake Villages E,G,H,I,J Signature: o N 7�Hr <br /> a <br /> Project Address: bamp Ing V,,>Confainer I reserva 1 a rix a <br /> o f w 1O 1< o <br /> T LL <br /> n d 2WK <br /> Sample E 0 M o w w Q O <br /> N o 0o p <br /> Designation Date Time v = o = _ o) o <br /> S AA\ I <br /> �lS- 102.6 <br /> ;i,A w) I I <br /> SL" D 5b <br /> Relinquished by: j Date Time Received by: Remarks: <br /> I/ / please send copy of report to jcoburn@wallace-kuhl.com <br /> Relinquished by: Date Time Received by: <br /> Relinquished by: Date Time Received by Laboratory: / Bill to:Wallace-Kuhl&Associates c/o <br /> l <br /> /-_7 / WKA Contact and swilliams@wallace-kuhl.com <br /> �� v <br />