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PRECISION ENVIRO-TECH CHAIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCUMENT <br /> CLIENT <br /> DE TAILS1 <br /> w <br /> .�-- f Rush Analysis: 5 Days 2 Day�s_24hrs <br /> Client: So ��c _ Sampier(s). Gr I C <br /> e6_1J <br /> Subject to surcharge <br /> Customer Number: (�9S � '370 l QA/QC report required: yes no <br /> Comp Sampler Set Up Date:— Timer_ <br /> tt L 1 <br /> Address: 22 f'1 oyIf yes,To: State Client Other <br /> Time: Mileage: <br /> Lab number: <br /> 1 � <br /> 'FtoneZo9� 3�7`37 � - <br /> x � <br /> I 7 t <br /> * <br /> FAX:� � 3o � �_. �� r <br /> d � <br /> Project name: z <br /> t+ <br /> Contact person: < < o� 6 �F z o t . z cc ;e ° 1 R <br /> 3� 33` xO _ STW <br /> IS a I f ��r <br /> O <br /> Sample Date Time € a x Q) �°j C 1 <br /> Number Location Description Sample Sample Z> <br /> f � - <br /> r - � <br /> Q <br /> �i <br /> 9 <br /> n <br /> b ' <br /> D i IJ <br /> n v Date 7 mime Received by: ti Date? �r V�Ti.oe <br /> n Relinquished by: f <br /> N Relinquished by: Date Time Received by Date Time <br /> Y: <br /> 4 <br /> Relin uished b Date Time Received by: Date Time <br /> fl <br /> P-'�RIST""'"EN`rr"O-Trr';H 77A'�N.R'Pst Teane. Suite 132* Stockton CA 95210x*Telephone(209)477-8105FAX: (209)477 8148 " <br />