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Reporting Information ��� <br /> 1 Client WICKLAND PROPERTIES American Environmental Nenvork Page of <br /> Address x 13648 3440 Vincent Road,Pleasant Hill,CA 94523 REQUEST FOR ANAL YSIS 1 CHAIN OF CUSTODY <br /> SACRAMENTO , CA 95853 4648 Phone(510)930-909Q <br /> Contact W FAX(510)930-0256 Lab Job Number <br /> All Contact Lab Destination <br /> Date Samples Shipped <br /> Address Report To Send Invoice To Lab Contact <br /> 2 WESTERN GEO-ENGINEERS 3 SAME AS 1 Date Results Required <br /> Date Report Required <br /> E R STREET Wnnl)T.AND CA q5226-6001 Client hone No <br /> Client FAX No <br /> Send Report To 1 I�oo�r(2 Circle one) <br /> ANALYSIS <br /> Client P O No 60Client Project 10 No <br /> Sample Team Member(s) Cga e e�CiCrfC <br /> i <br /> r` <br /> Lab Client Sample Air Date/ Sample No Type <br /> Number Identification Volume Time Type. Pres of off <br /> Collected Cont Cont Comments 1 Hazards <br /> y7 lam«4 ! Q�rf <br /> !wr <br /> Cin y� ti� fir` E <br /> 4-J .Z6o h+eae� <br /> Y-.5"a a <br /> a <br /> ! W <br /> QS� <br /> 543 S -clr 1 nrh <br /> Relinquished byAT TIME Received by DATE TIME <br /> (Signature) G�s"�9'7 6ri, (Signature) <br /> Relinquished by:: <br /> DTE <br /> (Signature}ature) I �r Received by D T TIME <br /> �, (Signature) 6 ,5-,f 7 2 <br /> Relinquished by D TIME Received by DATE TIME <br /> (Signature) <br /> arure} (Signature) <br /> Method of Shipment Lab Comments <br /> Sample type(Specify) 1)37mm 0 8 pm MCEF5' 0 8 pm MCEF 3)25mm 0 4 pm poiycarb filter <br /> 4)PVC filter dram pore size 5)ChIbtube 6)Silica gel tube 7)Water 8)Sod 9)Bulk Sample . <br /> 10)Other 11)Other <br />