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PRECISION ENVIRO-TECH ACHAAINIO Q ESSTDOCOUMMENT <br /> CLIENT DETAILS SAMPLING REPORT INFORMATION <br /> LL Rush Analysis: 5 Days _ 2 Days_24hrs <br /> Client: IJ,-�L 0. AA10a snJ S 4s(; G- Sampler(a): <br /> Subject to surcharge <br /> Customer Number: Comp Sampler Set Up Date:— Time: QA/@C report required: yes no <br /> Address: o�� OUS rD� L 1, Time: Mileage: Lab <br /> yes,To: State _Client _Other <br /> Lab number: U <br /> Phone: 6,2 :3&7 - 3,70/ x <br /> way3 m P <br /> FAX: d m "a ° a 3 m^ <br /> U <br /> Project name: fd/k)(' /416t-n dE5Fa - O Fsv 2 <br /> u1 fi G}� <br /> Contact person: `�A V� 8 d a <br /> z o ;� <br /> d <br /> SAMPLE INFORMATION 1� :4 <br /> W � � <br /> 9 S a p" o� <br /> Sample <br /> Number Location Description Sample Sample z? <br /> CUSTODY <br /> Relinquished by: Date - ime 00 Received by: Dat q G �'lme <br /> Relinquished by: Date _Time Received by: Date /Time <br /> Relinquished by:777 _� Date _Time Received by: Date Time <br /> PRECISION ENVIRO-TECH 545 E. Cleveland, St. Suite A* Stockton CA 95204*Telephone(209)462-0892 * FAX: (209)462-7935 <br />