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PRECISION ENVIRO—TECH CIIAIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCUMENT <br /> CLIENT DETAILS REPORT INFORAUTION <br /> Client: Ne�� . An ( i�j .� _ F Q�j f <br /> Rush Anal}'sis: 5 Days _ 2 Days 24hi:> <br /> lr! �� Sam ler(s): -Tsti� rel t1a r <br /> Subject.W sumhnrge <br /> Customer Number:� Ir S <br /> Comp Samples' Set.Up Date:_Time: QA/QC,report required: yes no <br /> i <br /> Address: qna? l}i' us ;4 aki Time: MLeage: If yes,To. State —Client _/Other <br /> Lo�1 C A q5L– Lab number: <br /> Phone: zncl <br /> �r�G <br /> FAX.: 201 c3& t +Z Z-6 <br /> EE r <br /> Project. name: y_din de PC I FV v_Ar �(_ { _ ;E- <br /> v fff <br /> Contact person: z z f a <br /> _F F <br /> .- •5 4 L y -r :Za. I <br /> SAMPLE <br /> Sample Date Time =5 - 3 T c`� g I <br /> Location Descri tion = _ 3 3 r - 2 <br /> 'Number g Sample Sample r C �' vY U <br /> � A a o C? VW — fi r k <br /> �xT" FA�cr� of 5� <br /> r , ' <br /> 7- Relinquished by Date l l! b'Pi. Received by Date 4T'ime <br /> Relinquished b)- I)ee Time Received by: Date Time <br /> Relinquished by: Date Tints Received by: Date Time <br /> PRECISION ENVIRO-TECH 545 E. Cleveland, Suite A' Stockton CA 95204'`Telephone(209)482-0892*FAX:(209)402-7935 <br />