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PRECISION ENVIRO-TECH CHAIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCUMENT <br /> CLIENT DETAILS I <br /> �,.c (� �� 1 � � Rush Analysis: 5 Days _2 Days_24hrs_ <br /> Client: I f 1`!,j +nxryY{I (t ) Sampler(s): � <br /> ADVO <br /> Subject to aurcbarae <br /> Customer Number: �t K� QA/QC report required: yes_ no <br /> Comp Sampler Set Up Date:— Time: <br /> � n W WPI r al, r��P� If yea,To: State _Client _Other <br /> Address: Q�� I — /� �J(� Time: Mileage: r ©$ 2 So <br /> n J//''I �l!k'I' 4 ( A g5/�t/k7 Lab number: <br /> Phone: I�q)Z - 2760 x <br /> FAX: 3 a a 3 e a <br /> Project name: 1A <br /> 6 <br /> Contact person: <br /> 'LJyVcc LEc- <br /> m e s z o 1 m <br /> $� 3q3 <br /> SAM13LE INFORMATION , a4� <br /> Sampleete Time <br /> Number Location Description fkmje I Sample I <br /> I S <br /> Relinquished by: Lam- Dat -= i Time �� H� Receive y: DatJz ime fO; <br /> Relinquished by: Date _Time Received by. Date Time <br /> Relinquished by: Date _Time Received by Date Time <br /> PRECISION ENVIRO-TECH 3936 N.Coronado Ave.*Stockton CA 96204*Telephone(209)477-8105*FAX: (209)546-7497 <br />