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PRECISION ENVIRO-TECH CHAIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCUMENT w <br /> DETAILS <br /> F- <br /> N <br /> Rush Analysis: 5 Days'Z I)ays_24hrs m <br /> Client: �yf4tJCe 6 ED _ Sampler(s): !* �...� -- CD <br /> r Subject to surcharge <br /> Customer Number: D <br /> �1ec <br /> Camp Sampler Set Up Dater Time: QA/QC report required: yes—_ no" LO <br /> Address: Time: Mileage: If yes,To: State Client other <br /> N <br /> Lab number._ 1A - .0l TV, p� Lo <br /> 01 <br /> Phone: <br /> 03 <br /> FAX: , <br /> Project nameHATN3 ST <br /> ro <br /> a RE <br /> P �— � riC <br /> Contact erson: ' s o m <br /> z �A - 4 z 0 Aj <br /> 03 <br /> ample Date Description o ° mNumer Sample Sample D <br /> Cn <br /> 1 k 1 C a2 I�,,3o MT v $ o <br /> 2 )Q IL * J SpiATA E 11 o <br /> !�-z1 MT R E 5;:ItoAf <br /> �, ►� s z <br /> T _N ►I <br /> 'Ift N i 3 ZN -NO k 1161.20 - <br /> (e TA N It- It-5 L E r-Jb 0 4 5:IO It )t S <br /> ENDRIRI 11 <br /> Relinquished by: Date TimeReceived by: f p$ (1� / ' tt M <br /> Time �ri "I� M <br /> Relinquished by: _Date Time Received by_ Date Time W <br /> Relinquished by �o <br /> _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)462-7936 <br />