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Reporting Inlormaftnigft AEN <br /> American �Cnvironmental N rk <br /> !. Ment WI AND PROPERTIES t'ago <br /> Address: 3440 Vincent Road,Pleasant Hill,CA 94523 REQUEST FOR ANALYSIS/CHAIN OF CUSTODY <br /> SACRAMENTS, CA 95853 -464'8' Phone(510)930-9090 <br /> Contact: FAX(510)930-0256 Lab Job Number: cl- 12-2-IRS <br /> AIL Contac Lab Destination: <br /> Date Samples Shipped: <br /> Address Report To: Sond Invoice To: Lab Contact: <br /> Dale Results Required: <br /> 2. WFSTERN GEO--ENGINEERS 3• SAME_ AS 41 Dale Report Required: <br /> BEAMER „STREET - -_ Client Phone No.: <br /> 3jnnnr,,AWn. ra 9S779-6003 - Client FAX No.: <br /> Send Report To: i or 2 (Circle one) ANALYSIS <br /> 1'_ <br /> Client P.O.No.: Client Project I.D.No. 603. _ <br /> Sample Team Member(s) .1s cl/_ AML _ <br /> Lab Client Sample Air Dale! Sample Pres. of <br /> Number Identification Volume Collected Type" Cont Cant. Q Comments 1 Hazards <br />[MIA 12-17-27 12-76 Cl- 5 vo <br /> W 2- 12-17 /2:50 <br /> r7 - 2-17 7 Z J <br /> 05A - 2- 7 J ✓ J <br /> OGA-9 - 6 f2-16-97Y2- <br /> /17 <br /> 2 ✓ rl <br /> 4 /r7 tv - 1-2-16-27' 1: 0 ✓ <br /> 11.17- 0-'50 J <br /> z•! 11- 5,9 ✓ J <br /> - ra 12-17- y' 2 : 50 <br /> 1 12- -1 - 4 fV J ✓ r <br /> 2.17- <br /> 2 G <br /> 0- 4— <br /> !2- .17.97 3 ' 1 V ✓ <br /> Ili Rellnquished by: DATE TIME Received by: DATE TIME <br /> (Signature) .12-16-,97 l : (Signature) ; <br /> l2-rf 7 �2;0 <br /> Rerurquished by: DATE TIME Received by: DATE TIME <br /> (Signature) - f 2 r I g- (Signature) j 9-1 ( • 1 <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 pm MCEF 3)25mm 0.4 pm polycarb.filler <br /> 4)PVC filter, diam, pore size 5)Charcoal lube 6)Silica get lube aWaler 8)Soil 9)Bulk Sample <br /> 10)Other I 11)Other <br /> COPIES: WIITE-JOri FILE YELLOW-Pn0KCT FILE PINI(-CLIENT <br />