Laserfiche WebLink
PREEISION ENVIRO-TECH CHAIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCUMENT <br /> DETAILSCLIENT REPORT INFORMA.rrION <br /> Rush Analysis: 5 Days __.. 2 Days_24hrs <br /> Client: <br /> 7S. er(s); <br /> Subject to surcharge <br /> Customer Number: Comp Sampler Set Up DateLLlf'Time: QA/QC report required: yes no <br /> ` <br /> Address: 'Fiore: n` If yes,To: State Client Other <br /> �' �'r.. Mileage: <br /> Lab number: <br /> Phone: <br /> FAX: c A s A a <br /> v N <br /> Project name: aSC2'-J 714J0 E- <br /> a v <br /> •�s cn d m 3�,Q � <br /> s P° <br /> Contact person: a �N � �y � z o � <br /> •a �� � 3aa � o � y � <br /> OSAMPLE 3� <br /> Sample Date <br /> Number Location Description Sample Sample <br /> 777 CUSTODY <br /> Relinquished by: Datel/�'p ime Received by: DateSE� ime t 9W <br /> Relinquished by: Date Time Received by: Date// 'Time <br /> Relinquished by: Date -Time-Received by: Date Time <br /> I <br /> PRECISION ENVIRO-TECH 7743 N. West Lane, Suite$2 * Stockton CA 95210*Telephone(209)477-8106 * FAX: (209)477-8148 <br />