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rteporling Information: <br /> American Environmental Network AEN Page of <br /> 1. Client: f -r fL4�u CAR MAR Z 5 1996 <br /> �ZO �r 4 3440 Vincent Road,Pleasant Hill,CA 2 <br /> Address: tit `' O Phone(5 10)934-9090 REQUES70R ANALYSIS/CHAIN OF CUSTODY t,e <br /> �t�K-'1�1n0 �f 1�, ' <br /> Contact: _ W' '�P,.. ' u saw FAX(510)934-4256 Lab Job Number: b o <br /> Alt.Contact: Y q 4t lotA - Lab Destination: <br /> Date Samples Shipped: <br /> Address Report To: Send Invoice To: Lab Contact: <br /> Date Results Required: <br /> 2' 3' Date Report Required: <br /> Client Phone No.: <br /> Client FAX No.: <br /> ANALYSIS <br /> Send Report To: 1 or 2 (Circle one) <br /> Client P.O.No.: Client Project I.D.No.: <br /> Sample Team Member(s) <br /> Lab Client Sample Air me Sample Pres. of Ty <br /> Number Identification Volume Collected Type Cont. Cont. Comments/Hazards <br /> d 16-G MW - f 3 pf` [ U -w4 <br /> 0?,A--G M u7 - 15 0C <br /> 03f)c, N1 - 6 <br /> ou <br /> . .� <br /> i e <br /> Relinquished by: <br /> 11T TIME Received by: ,+ A TI F, <br /> (Signature) �'l Ci •C/� (5lgnature) !t' � �"- l �r h� <br /> 'o <br /> Relinquished by: ^ F p�AT t' f T M Received b . '. _. DATE r <br /> (Signature) /'�/�D /d (Signature) J j 5.. <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.B pm MCEF 2)25mm 0.8 pm MCEF 3)25mm 0.4 pm polycarb.filter <br /> 4)PVC filter, diam. pore size 5)Charcoal tube 6)Silica gel tube 7)Water e)Soil 9)Bulk Sample <br /> 10)Other 11)Other <br />