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porting Information: ` E i <br /> . Client: <br /> WICKLAND PROPERTIES At1zericai2 Environmental NeIv !/-�� ,L r Page of '• <br /> Address: 48 3440 Vincent Road,Pleasant Hill,CA 94523 3 <br /> .SACRAMENTO ,_ CA 95853 -4648 <br /> Phone(5 10)930-9090 REQUEST FOR ANALYSIS/CHAIN OF CUSTODY <br /> Contact: jOHN MARG_OWSKI _ FAX(510)930-0256 Lab Job Number: <br /> All.Contact: Lab Destination: <br /> Date Samples Shipped: <br />(dress Report To: Send Invoice To: Lab Contact: <br /> Date Results Required: <br /> WESTERN GEO—ENGINEERS 3. SAME AS ffl Date Report Required: <br /> 1386 E.__SEAMER STREET_ Client Phone No.: <br /> WnnnT.ANo , cA g9726-6003 Client FAX No.: <br /> rld Report To: 1 or, 2 ircte ANALYSIS <br /> one) <br /> nl P.O.No.: Client Proiecl I.D.No.: �'"" '' i <br /> ple Team Member(s) kwe <br /> Lab Client Sample Air Ti e!me Sample Pres of TyOl e <br /> umber Identification Volume Collected Type' Cont. Cant. Comments 1 Hazards i <br /> .j <br /> Minquished by: DATE TIME Received by: DATE TIME <br /> ignature) X, f 7 (Signature) (p_' O <br /> �/ <br /> Clnquished by: DATE TIME Received by: DATE TIME <br /> gnature) (Signature) <br /> "Z <br />�tinquished by: DATE TIME Received by: DATE TIME <br /> gnature) (Signature) <br /> ethod of Shipment Lab Comments <br /> 'Sample type(Specify): 1)37mm 0.8 Nm MCEF 2)25mm 0.8 pm MCEF 3)25mm 0.4 pm polycarb.filter <br /> ` 4 PVC filter, diam. <br /> } pore sire , 5)Charcoal tube 6}Silica gel lube 7)Water 8)Soil 9)Sulk Sample <br /> 10)Other 11)Other <br /> i <br /> 1 COPIES: WHITE•JOB FILE YELLOW•PROJECT FILE PINK-CLIENT <br />