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7 'l := 111�"`1 Ham. k7-1 <br /> PRECISION EN` ORED=TEEN CHAIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCUMENT <br /> Ll I will <br /> Rush Analysis: 5 Days _ 2 Days�24brs <br /> Client: �il.d ON �r �'Lu¢t,i- q Sampler(s): ,NA4K- HkAioaL <br /> ` Subject to surcharge <br /> f <br /> Customer Number: <br /> Comp Sampler Set Up Date:— Time: QA/QC report required: yes no <br /> i' <br /> Address: ��Z�a W. �IC EM4MAAr__ L. � Time: Mileage: If yes,To: State Clien^t� Other <br /> �v�T Lux /.k 52�t 2 <br /> Lab number: <br /> Phone: <br /> s x , <br /> 3 � <br /> FAX: (Zai) a a W bax <br /> Project name: t�o[1.E,z F A a <br /> v <br /> ' to <br /> Contact person: Nair& ',� <br /> a <br /> � <br /> 333 n °i1 t o du Q <br /> Z&RE <br /> • 0 ■ A o v`z"" CQ73 " 5 a °�W C' <br /> Sample Location Description Date Time v '2-.4 <br /> � : m <br /> Number p Sample Sample z> U <br /> ;& <br /> Relinquished by: Date;141-1 Time Receiv Peteime-/ - I A� <br /> Z <br /> Relinquished by: Date Time Received by: Date ime <br /> Relinquished by: Date Time Received by: Date Time <br /> PRECISION ENVIRO-TECH 7743 N. West Lane, Suite B2 *Stockton CA 95210 *Telephone(209)477-8105 *FAX:(209)477-8148 <br />