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PRECISION E VIRO-T ECR CHAIN of CUSTODY <br /> ANDAIYALYSIS REQUEST DOCUMNNT ; <br /> CIAENT DETAILS <br /> CClient: J\ASampler(s}: <br /> p Rush Analysis: 5 Days _ 2 Days_24hrs <br /> _ •� <br /> Subject to srsrcatarge <br /> Customer Number: --- Comp Sampler Set Up Date:^ Time:—_ QA/QC report required: yes no <br /> Address: _ Time: Mileage: If yes,To: State Client Other <br /> Lab number: <br /> 'hone: . _ <br /> a <br /> FAX: - 4 <br /> ! a <br /> Project name: �� r <br /> �2 <br /> Contact person: CA <br /> 3 s x Z rS a <br /> q C) o�f s ch ti L _2 <br /> a <br /> Sample Date Time <br /> Number Y•fl catzon Description Sample Sample a e a <br /> e5 ems,c 4 S <br /> c \I— <br /> Relinquished by I \ `-�, D1te/i� _Timo.�I ,�-�_fj. Received by: �'n �•.% a Data`51 Time 11 ?C� <br /> Relinquished by: 1 __-Date Tirree Received by: Date Titre <br /> Relinquished by: _-_Data Time_ Received by: Date Time <br /> PRECISION E+NVIRO-TEC$ 7742 N. ,Vest Lame, Suite B2*Stockton CA 95210*Telephone(209)477-81©5$FAX: (208)477-8148 <br />