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PRECISION ENVIRB-TECH CHAIN OF CUSTODY <br /> AND ANALYSIS REQ VEST DOCUMENT <br /> tREPORT INFORMATION <br /> Rush Analysis: 5 Days _2 Days_24hra <br /> Client: DI(,L7Sampler(s): Yft � <br /> Subject W surcharge <br /> Customer Number: M QAIQC report required: yes_ no <br /> Comp Sampler Set Up Date:— Time: <br /> Address: 04-n N C� AE• '5vt 2 Time: Mileage: If yes,To: State —Clienntt/—Other <br /> L +_ <br /> _�`.�-i—"�—�7 q r) Lab number: <br /> Phone:_ ���� 33 1 -x(013 x <br /> S 3 = p q m <br /> FAX: I-L&91) 331- o-7Z3 a =mo <br /> F ? z E cs <br /> vs,�z w <br /> Project name: <br /> [] ���� / 2 nZ] GAJ <br /> Contact person- C _cF Z u 2 <br /> 14 a ty. C Oi <br /> E <br /> 2f t `a <br /> SAMPLE a <br /> a v 4.� •r u <br /> ime u <br /> umDate T <br /> NE^ e. 3� <br /> uvber Location Description samptc sample L Zs € _ �. « — <br /> R 27�i'd Ygcl= TOn,E R� S/B 08 - <br /> - <br /> Relinquished 6y: )a te'k Time ��••Si—Z Received hp: 22V Dafq Time <br /> Date 71me Received 5y: �Dale__Ti,ue <br /> Relinquished by: <br /> Relinquished by: Date _Time RcwiAed by: hate Time <br /> ' , P1tLC1Ri0N r,NVMO-V Cr1 7J48 N. West Lane Suite D'* Stockton CA 95210 t Telephone; <br />