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PRECISION ENVIR,O-TECH <br />CHAIN OF CUSTODY <br />AAFD ANALYSIS RF -Q UI:ST DOCU3I-.VT <br />f.Days Client: �-�a i't't.lil /lv�t� �/ iL� Sampler (s): Analysis: 5 Days � 1!•�T l�•� � 1���'� — 2 D24hrs <br />y — <br />/� `� C mpo ite Sampler Setup: Tush <br />Subject to surcharge <br />Customer Number: t": d <br />Date: - C' Time: QA/QC report required: yes no <br />Address: �� �� �� &L DG �'hC `i� c1' Subject to Surcharge Field Sampler: If yes, To: St1 Client Other <br />i Time Milage: _7 'Y <br />j <br />// Lab numher- ���� �/✓'-n <br />Phone: � -L� '' e 32 CONDITION <br />s <br />FAX: 2-e) C/) y -3CZ/G � � -y -t � _ � � Sample Temperature: S G Celsus <br />e, <br />` _ «E c z a <br />Leaking. () Broken. { ) VOA Headspace <br />Project name: d e Q <br />Custody Seal yes ( ) no <br />�� % <br />Contact person: `t(-f� • ' • <br />m _ <br />• ? 3 a a y / Ice Chest,'( ()UPS ( )Fed Ex ( )Dro off <br />SAMPILE • s v P ()Other <br />ll <br />Sample, - �"3 t L <br />TION <br />P Date Time � ` c', m � - <br />Number Location Description r ; - 3 5 Z • • <br />S n ple Sample z> u. m <br />r rt <br />Relinquished 1-: <br />Relinquished by: <br />Relinquished by: <br />�' -- Date 7 % f('1'imeq <br />Date Time Received <br />Date Time Received <br />Dat1/I// 1Pime _�/' <br />Date Time <br />Date Time <br />3935 N. Coronado Ave. * Stockton CA 95204 * Telephone (209) 477-8105 " FAX: (209) 546-7497 * Email: jhvle@petallab.com * www•.petallab.com <br />