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t. Client LAND BRO>?ERTIES <br /> A111C1ICan Enwronniental 0101k AEN Page___.0- <br /> Address 0 W. , 130K 13640 3440 Vincent Road,Plca%anl Hill,CA 94523 REQUEST FOR ANALYSIS I CHAIN OF CUSTODY <br /> _,Sacramento-,CA_958'53-4618 Ptionc(5 10)970-9090 <br /> Contact John arg°Wgki 17AX(510)930-0256 Lab Job Number- <br /> Lab Destination <br /> Alt Contact Dale Samples Shipped <br /> Address Report To Sand tr►vateo To Lab Contact <br /> Date Results Required <br /> 2- Western Geo—Engineers 0- Same As #)1 Date Report Required <br /> 1386 C. Beamer Street Client Phone No <br /> Woodland, CA 95776-6003 Client FAX No <br /> ANALYSIS <br /> Send Report To, 12 (Circle one) r� <br /> Client P 0 No _ -- Client Prolecl I D NO <br /> Sample Team Member(s) - <br /> i <br /> Lab C(ten(Sam�Ie .Air Dale/ 5ampll: No T e <br /> Number Indenlllscalton Volurne Tte Type' Pres o! opf <br /> Gale cied Cont Cont Comments/Hazards <br /> Z 4 T <br /> I <br /> Relinquished by D TE TIM--- Z�EE Received by DAT TIME <br /> (Signature) �4 (Signature) -3, <br /> RoUnquished byDATE TIME Received by DATE TIME <br /> (Signature) (Signalure) <br /> elmquished by DATE TIME I Received by DATE TIME <br /> (Signatutel (Signature) <br /> ethod of Shipment Lab Comments <br /> 'Saraple type(Spealy) 1)37mm 0 8 pm MCI=F 2)25mm 0 8 pm MCEF 3)25mm 0 4 pm polycarb Idtar <br /> 4)PVC filler diam pore size 5)Charcoal tube 6)Silica Vol lube 7)Water 8)Soil 9)Bulk Sample <br /> 10)Other_ _ It)Other <br /> COPIES WtIITE "FILE YELLOW PrINIECTFILE PINK CLIENT <br />