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PRECISION ENVIRO-TECH CHAIN OF CUSTODY <br /> D ANALYSIS REQUEST DOCUMENT <br /> ' CLIENT DETAILS SAMPLING REPORT INFORMATION <br /> '' Rush Analysis: 5 Days _ 2 Days_24hrs <br /> Client: IJI EL 0. As)f)c2� IJ � p' Sampler(s): <br /> Subject to surcharge <br /> Customer Number: Comp Sampler Set Up Date:_ Time:_ QA/QC report required: yes_ no <br /> Address: ;2�`1 }InuSTD .1 Time: Mileage: If yes,To: State —Client —Other <br /> L.pDr e,:44 cv.SZ/ L/ <br /> 2- Lab number: /J ('�5^ I <br /> hone: (,20 i�'�-370/ x <br /> FAX: G s a s A A <br /> a a a W c z O 4 <br /> 4 'ouo O a n g+ <br /> G q µ <br /> Project name: PttLUdl1)c�l _ s U s so N 2 <br /> a <br /> y <br /> Contact person: 1Jt <br /> z <br /> SAMPLE 2 . m v x <br /> U 1; v <br /> Sample Date Time �v3 <br /> �< a° wUgg3 <br /> Number Location Description Sample Sample F x° a_' <br /> l 53 1. SZ o2 6/p6/pi P I DV4 3 <br /> CUSTODY <br /> Relinquished b ate ime_2:_5'8p Received by: Date Time Z ' 61 7 <br /> Relinquished by: Date _Time Received by: Date Time <br /> Relinquished by: Date _Time Received by: Date Time <br /> I <br /> PRECISION E NVIRFEC 1 545 E. Cleveland, Suite 1* Stockton CA 9204*Telephone(209)462-0892 * ) AX: (209)462-7935 –A <br /> _J <br />