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CHAIN Jr `Ui; fJJ'( t ,PRECISION ENVIROJECW' <br /> CLIENT INFORMATION k "�,: .REPORT INFORMATION _ s, <br /> Customer ID: ADGEO Rush Analysis: 5 days: r 2 Days: J 24 bra: Q <br /> Company Name: Advanced GeoEnvironmental, Inc. Subject to Surcharge <br /> Adress: 4005 N.Wilson Way QAlQC report Required: Yes: I• No: C <br /> City: Stockton If yes,To: State: r Client: r Other: r <br /> State: CA. LAB SAMPLE NUMBER: <br /> Zip Code: 95205 ]- <br /> Phone: (209) 467-1006 fx <br /> K= SAMPLING INFORMATION.i z <br /> Fax: (209) 467-1118 <br /> Contact Person: William Little Sampler(s): -Jqhlr,'Rl�Gltli/l ('P Employed by: <br /> Comp Sampler Setup Date: ��.��. Time: <br /> Sampling Charge: Yes: FN_:. No: rT .. <br /> If Yes-Time Travel to Site. Mileage: <br /> °:SAMPLE INFORMATION ., <br /> Sample Location Description Date Time Type of Sampling Type of Sample Matrix Preservative ANALYSES REQUESTED <br /> No. Sample Sample Container _ <br /> _ Com sne Plastic/Glass /1 /., <br /> — lank # 1 � i��I y g;�? Grab rasp u►� 5c( Is _f�oNE__ YEA I CPN GA5 , Mt , d ll <br /> Composite Run./Glass L _ TPM/ (f <br /> lUM�H Y�/�+{YJ Z I'a� Grab JGiIS S C�j GaI ut i (� <br /> Camwsite Plastic/Glass Dr'.�1 .I1 ,1,t1 (y.�� .1{� <br /> �IC 1 I I ,1 `..MS 11�,L�� I 1 V_ ' <br /> Com s I Plastic/Glass <br /> _66 4;15 - 01 A 6m id � 6z6v I CAP, t� <br /> �` �}q'., Composite <br /> Plast IGI <br /> / y I J <br /> Ga�/� '.Is'A���II��/I� I•,,ty-j - �UIIS rL i.n,�/C __ _ .../' ,�( )) n .'(-G-y _ _ ._ _ <br /> Relinquished by: -Date-Time-Received by: wUl UGDate l,7 fT7Time 4 V?/` <br /> Relinquished by:. -Date-Time-Received by: Date Time <br /> Relinquished by: -Date-Time-Received by: Date Time <br /> PRECISION ENVIRO-TECH 2040 E.HARDING WAY, SUITE B STOCKTON, CA.95205 <br /> PHONE: (209)462-0892 FAX:(209)462-7935 E-MAIL:JONL1597@AOL.COM <br /> Pink- Field Copy White-Report Coppy Yellow-Laboratory Copy <br />