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PRECISION ENVIRO-TECH ACHANAALYSIOQCUUESTDOODYT <br /> REPORTCLIENT DETAILS SAMPLING O' <br /> Rush Analysis:5 Days_2 Days_24hrs <br /> Client: NiEo a• AnJoe-9664 3 g56oc• Sampler(s): <br /> A)0A Subject to surcharge <br /> Customer Number: QA/QC report required: yes no <br /> Comp Sampler Set Up Date:—Time: <br /> Address: ;�2 I&OS 7bn1 e-A) Time: Mileage: If yes,To:State// Client Other <br /> LSO t GA . yS2°}2 Lab number:I6 37( I <br /> Phone: (_20-1) 3 6:2 3701 x <br /> FAX: m e m m o o r <br /> s a9m v o Z x <br /> P <br /> N <br /> Project name: J�Sg'�S =,Q°dE F3 F o 2 <br /> 33 pp�� N <br /> A <br /> AVE <br /> Contact person: a�14GN <br /> z z (W1 n 0 oa �' d <br /> Q <br /> SAMPLE <br /> Sample Date Time <br /> Number Location Description Sample sample z a 3 a d U <br /> 73 W• Q,JeK Eb. 13 /7:45 <br /> JESSI�S C-tR-o�E <br /> I t4 DIVI V.1 14 <br /> 11 <br /> Relinquished by: Date 8 / Time / /s Received by: Dat 62Time !Z <br /> Relinquished by: Date Time Received by: Date Time <br /> Relinquished by: 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 />