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Reporting Information ,{ <br /> 1 Client <br /> WICKLAND PROPERTIES American <br /> Environmental Nehvor"k AEN Page--L of <br /> Address P.O. Ho x 13648 3440 Vincent Road,Pleasant Hill,CA 94523 REQUEST FOR ANALYSIS!CHAIN OF CUSTODY <br /> -SACRAMENTO , CA 95853-4648 Phone(5 l0)930-9090 <br /> Contact _JHHB RG OW S K I FAX(510)930-0256 Lab Job Number <br /> All Contact Lab Destination <br /> Dale Samples Shipped <br /> Address Report To Send Invoice To Lab Contact � <br /> Date Results Required <br /> 2 WESTERN GEO-ENGINEERS 3 <br /> SAME AS #1 Date Report Required <br /> 3386—E. BEAMER STREET„ Client Phone No - <br /> __ c)nDLAND} CA 9.927E-600"0 Client FAX No <br /> Send Aeport To 1 or /2 (Circle one) <br /> P-7NALYSIS <br /> Client P 0 No W /Clieent Project I D No <br /> Sample Team Member(s) � f -�IlCSR' <br /> Lab Client Sample Air Date/ Sample No Type <br /> Number Identification Volume Time Type. Pres of opf <br /> Collect Cont Cont Comments I Hazards <br /> 6 1053 <br /> S 6-- Cr J 1113 !d <br /> u-a I LyY-r7 <br /> 51?7_ z w� r <br /> Q7 - <br /> s O <br /> Relinquish7by DATE TIME Reeed b [ DAT TIME <br /> (Signature �'��r �...2 L ignature) ' U r b -2� <br /> Relinquished by DATE TIME Received by DATE TIME <br /> (Signature) (Signature) <br /> Relinquished by DATE TIME Received by DATE TIME <br /> (Signature) (Signature) <br /> Method of Shipment Lab Comments <br /> 'Sample type(Specify) 1)37mm 0 8 pm MCEF 2)25mm 0 8 um MCEF 3)25mm 0 4 fim poiycarb filter <br /> 4)PVC filter diam pore size 5)Charca 6)Silica gel tube 7)Water 8)Soil 9)Bulk Sample <br /> 10)Other Other S <br />