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CHAD JF cus'roJ'f PRECISION ENVIRO-TECH <br /> CLIENT INFORMATION REPORT INFORMATION <br /> Customer ID: NSPBC Rush Analysis: 5 days: ❑ 2 Days: ❑ 24 his: ❑ <br /> Company Name: Newark Sierra Paperboard Company Subject to Surcharge <br /> Adress: 800 West Church Street <br /> QA/QC report Required: Yes: ❑ No: ❑ <br /> City: Stockton If yes, To: State: ❑ Client: ❑ Other: ❑ <br /> State: CA. LAB SAMPLE NUMBER: � �X26 —6/' 102 "0_3 <br /> Zip Code: 95203 0"/ <br /> Phone: 209-466-7088 SAMPLING INFORMATION <br /> Fax: 209-942-1214 �� <br /> Contact Person: David K. Wong Sampler(s): '3. y. 0" 40, Employed by: <br /> -- REMARK: Comp Sampler Setup Date: Time: <br /> Sampling Charge: Yes: ❑ No: ❑ <br /> PROJECT: If Yes-Time Travel to Site: Mileage: <br /> SAMPLE.INFORMATION <br /> Sample Location Description Date Time Type of Siarripling Type of Container Sample Preservatha ANALYSES REQUESTED <br /> No. Sample Sample i Matrix <br /> lock X, <br /> a 'vdA 'S <br /> Compositto i (2 }.�� I,20p � JRW `+ *mom <br /> TH 91Ql t EPA 625 <br /> t00 �� It Composite / Rw i( it <br /> Composite tI 7t J� <br /> 13 Y4 i ��19 , (( 1!5) ✓ VIA; I{2�y u n <br /> �( (1 f Composite � / ,_I <br /> 4 Mil- l'f I I( II q - ra V <br /> Composite <br /> 5 G,im <br /> P -Plastic DW -Drinking Water <br /> CUSTODY S -Sterile wk-Wasp Water <br /> Cs -Glass S. I-Sol.So W,Sludge <br /> Relinquished by, Date Time Received by: Date Time <br /> Relinquished by: Date Time Received bv: Date Time <br /> Relinquished by: Date Time Received by: Date Time <br /> PRECISION ENVIRO-TECH 2040 E. HARDING WAY, SUITE 8 STOCKTON, CA. 95205 Pink-Field Copy White-Report Coppy Yellow-Laboratory Copy <br /> PHONE:(209)462-0892 FAX: (209)462-7935 E-MAIL:JONL1597@AOL.COM <br />