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NPRECISION ENVIRD-TECHCHAIN OF CUSTODY <br /> WDAJVALY.S1SREQUEST DOCU.&JENT <br /> Rush Analysis- 5 Days 2 Days_24hre <br /> — <br /> Client:- u e,t4 G -- ---. Sampler(s): y <br /> Subject to surcharge <br /> Customer Number: 1�1_J�! - ----- -- <br /> Comp Sampler Set Up Dater Time: Qr11QC report required: yea no <br /> Addl ep: __------ --_---- Time: Mileage: <br /> If yes,To: State Client _other <br /> m _ <br /> Gab number: 7 n 3(h u o? _u <br /> Phone: � c <br /> .$ it 3 <br /> FAX: r. J i g <br /> 'ppt� r <br /> (A <br /> Project name: <br /> J � <br /> Contact person: + G o a t -8 oa �m <br /> g�g U <br /> .iii X63 L oa <br /> Sample Date Ttme <br /> Loe8itloin Description Sample 9ampt0 � �> � ��a y � � � L' r°�?ya C> <br /> Number <br /> CU <br /> C 1 <br /> - <br /> M - <br /> -s— <br /> S' <br /> a <br /> V — <br /> co <br /> o Relinquished by: Date15,Lj Time_LL 1 Received by, �c, Dr�Ee 211 1�,',Time 1 `J', .1•:1 <br /> In Relinquished by:_�_ 1r'_--_ \1.. ' Date' �� <Time l?'4Cir�`I R.Eceived by I�t.l vl 1`.' 1 Date ^i 11SJ(1;Tim9 )-' 1�1�Ai <br /> O - <br /> ReWiquished hy: Date Tune Received by: Date Time <br /> r, <br /> PRECISION ENVIRO-TECH 7743 N.Fest Lane,Suite B2 f Stockton CA 95210-Telephone(209)477-5195 FAX:(209)477.8148 <br /> L <br /> N <br /> E <br />