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CHIN OF CUSTODY <br /> AND ANALYSIS REQUEST DOCOAMW <br /> ®eesw noose-s sa vnceu r.r nnw._we n , <br /> Q 7Q� Rush Analysis: 5 Days 2 Day+ 24hrs_ <br /> . IAt�' ol 0 n t �SSGG. Sampler(S): I <br /> Client: `� 5¢bjeci:to s[u>charge <br /> Customer Number: QA1QC report required: yes_ no _ <br /> Comp Sampler Set Up Dabs:.—Time: <br /> If yes,To: State —Client —01her ____ <br /> j ,r r Ci «c Time: Mileage: r <br /> Address/I:�_, h I.1 <br /> � a Lab number. 1 � ��l�f� <br /> Phone: <br /> ���j"�f pt/ � ZF <br /> ` F'a s <br /> PAS.: z <br /> � E R ` c X <br /> CM1 l-C.Y WSN NI F.•f Z <br /> Project name:2JZ. N q m <br /> z W ^m <br /> 1�( Y1Q IUC.I��/\ <br /> Contact person: I <br /> � � <br /> Samp leDate Time u 33 z rr t-7 y L- <br /> Number Location Description Sample Sample <br /> 34k� ZwS�elt+�e�OeP QR5 ( �D 3:r'S G— P P 6w <br /> 34Wra lxt anatAw S#Z 10- .0 543D Gr77 P P <br /> DR [Y_[�.altpimeg,3VP Remi y: ate Al <br /> Relinquished b}•. LefJ]y <br /> Relinquished by: Date <br /> Time Received by: Date me <br /> Relinquished by: Date <br /> _Time Received by: Date Time <br /> .0892* PAY(209)462-7935 <br /> PRECISION EIRO-TECH 545 L.Cleveland,Suite A R Stockton CA 95204 y Telephone(209)462 <br /> NV <br /> 1 ! 1 ! 1 1 1 1 I 1 ! 1 1 1 1 1 1 1 <br />