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PREC S ON ENV RD-TECH CHAIN OF CUSTODY <br /> A:ND"A. Y'SIS REQUEST DOCUMENT <br /> R" <br /> hush Analysis: 5 Dayfs ��2 Days 24hrs <br /> Client:MWM M7===7 <br /> (,sl: <br /> Subject to surcharge <br /> Customer Number: Comp Sampler QA/QC report require& yes nn <br /> ;art Up Time:�.. <br /> Address; Mileage: It yes,To: State Ghent Chher <br /> i <br /> tzb number: <br /> y... <br /> Phone: <br /> FAX a <br /> a z <br /> Project name: <br /> 6 ti a ? iris` . <br /> Contact person: aa+ff <br /> s' �T <br /> Sample Date Time � � i <br /> Number Location Description Sample Sample h y � �� � a�' r � � <br /> X ^ <br /> Relinquished by: Date Time Reeeived by: date Time <br /> Relinquished by, Date Time Received by: Date Tinie <br /> Reliiiquished by: Date Time Received by: Date-_--_-__Time <br /> PRECISION ENVIRO-TECH 3935 N. Coronado Ave. « S� ' ton CPS 95204 * 'i'elephasse(209)47 7-810 5 FAX:(2014)546-7497�n <br />