Laserfiche WebLink
t i <br /> PRECISION ENVIR11-TECH CHAIN OF CUSTODY <br /> ANDANALYSIS REQUE,ST DOCUMENT <br /> 1-ImPORT INFORMATION <br /> CLIEWDETAILS <br /> C`J Rush Analysis: 5 Days —2 Daps`24hrs <br /> j am- sample.(s): c -,� ( <br /> Client: <br /> customer Number' Comp Sampler Set Up Date:— Time: Q/VQC report required: yes na <br /> -_ o� r If yes,To:State Client Other <br /> Address:�r - '1'i��: � z�ti1�H�e: <br /> Lab number: <br /> c-A <br /> Phone: 310 to <br /> FAM J o TA <br /> Project name: L <br /> Contact person: �C ' c <br /> orq w <br /> 7 r �l� q <br /> Sample DateeSlf ° <br /> scrip.tic m– Time 0 <br /> Location m <br /> ocaon DSample ampe z <br /> — - h <br /> f _ _ <br /> { ''//�. e:Time:' 00 Received by: lL�l Data�Time. 1�0- <br /> Relinquished by. -� I/ <br /> —� Relinquished by% Date ___-Time Received b_y:_ Date___—Time --- <br /> Relinquished b}:_ Date _ Time Received bT Date Time <br /> PRECISION ENVIRO-TECH 7743 N.West Lane,Suite B2*Stockton CA 95210*Telephone(209)477-8105 x FAX:(249)477-8148 <br />