Laserfiche WebLink
PRECISION ENVIRO-TECH ACHAIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCUMENT <br /> CLIENT DETAILS REPORT INFORMATION <br /> Rush Analysis: 5 Days _ 2 Days_24hrs <br /> Sampler <br /> Client: Adv. G�y�>/�ny1 rpn wy, kln Subject to surcharge <br /> Comp Sampler Set Up Date:_ Time: QA1QC report required: yes no <br /> Customer Number: pp/Z <br /> Time: ILS Z�W'4Mileage: K4 If yes,To: State _Client _Other <br /> Address: Lab number: <br /> Phone: y <br /> v <br /> FAX: rrrA x <br /> Project name: <br /> a 5 S o O � � <br /> Contact person: <br /> D N <br /> U C W Oz O In l� \.. <br /> � 1�+f C. p0 W <br /> SAMPLE N <br /> Sample Date I Time <br /> Number Location Description Sample Sample z P. �2 't <br /> u� l&,A<#� 10 1 10.35 Ct M 50, E _ X X k <br /> 2gri11Cr# p 1D. 3G MT Sc; X <br /> CUSTODY <br /> Received by: cr Date /Time Ia y� Received by: Date Time <br /> Relinquished by, Date _Time Relinquished by: Date Time <br /> Received by: Date _Time Received by: Date Time <br /> PRECISION ENVIRO-TECH 2040 E. Harding Way Suite B * Stockton CA 95202*Telephone (209)462-0892*FAX:(209)462-7935 <br />