Laserfiche WebLink
- 0 <br /> ACporlrng lnformalron � <br /> 1 Client WICKLAND PROPERTIES A111C!!CC!!1 j�111�1! vlultclttcll Nelwv!k A.t:.rl r Page �_ of Z _ <br /> Address __I—,Q, 13ox 1 3646 34'10 Vincciil Road,PIC-leant I till,CA 94523 RE=QUEST FOR ANALYSIS 1 CI�IAIN OF CUSTODY <br /> m A 95053-4610 )'Bone(510)910 9090 <br /> Contact John +Margowski _ I AX(510)930 0256 Lab Job Number <br /> All Contact Lab Destination <br /> Data Samples Shippod <br />�Addross Report To Sond Invoice To Lab Contact <br /> 2 WesteLn Geo-£nginoers 9 Dalo Results Roquired <br /> Same As 1(1 Dato Report required <br /> 1386 C. BQamer Stt-eat <br /> Woodland, CA 95776-6003 Clientne No <br /> Client rAXPhoPhe Na <br /> Send Report To 1 or 2 (Circle one) <br /> ANALYSIS <br /> Client P O No Clrenl Protrrl I D No 3 <br /> Sample Team Member(s) 6- a"e-y - <br /> (a6 C1112111 Sam lc Air gale( Sample' ares of of <br /> No Type <br /> Number Indenlillcallon Volume T` t Type T <br /> Colleccd Con[ Cont � Comrnenh5l Hazards <br /> Relinquished by DATL` TIMC Recervod by AT TIME <br /> (Signature) <br /> f 7-L <br /> Relinquished by r TE�, TIME Recorved by S DATE TIME <br /> (Signature) �y '� �� _(� �/J� (Signahuro} ,� ?aLP-4 s <br /> rlelinqurshed by DATC TIME Recoivod by DATE TIME <br /> {Signature} (Signature) <br /> Method of Shipment Lab Comments <br /> r <br /> Sarrlpin type(Specify) 1)37mrn 0 8 Irm MCEr 2)25mm 0 8jim MCEF 3)25mrn 0 4 Irm polycaib hltor <br /> 4)PVC ldtrr diain pore size 5)Charcoal lubo 6)Silica gel tubo 7}Walar 8)Soil 9)Faulk Samplo <br /> 10)Other 11)Other <br /> rnlllr< Wr IiTC VVI fR L v❑i nw nnn irrr nm r <br />