Laserfiche WebLink
'i <br /> rz <br /> Y. <br /> INTERNATIONAL 'S <br /> TECHNOLOGY <br /> CORPORATION REQUEST FOR ANALYSIS RIA ContrCI No. 2 3 J H 2 <br /> PROJECT NAME `•-�"?� iii, ,�, C/C Control No. <br /> PROJECT NUMBER ( �(}r DATE SAMPLES SHIPPED 7_ f "s <br /> I.AB DESTINATION n — r <br /> PROFIT CENTER NUMBER = �t� — G 11 1PAL <br /> '' !" <br /> PROJECT MANAGER (- -ABORATORY CONTACT -, <br /> �r r, i.:_:�f d <br /> BILL TO SEND LAB REPORT TO <br /> DATE REPORT REQ � ! <br /> PURCHASE UIRED Z <br /> Cli <br /> A <br /> 8 � <br /> ORDER N <br /> O PROJECT CONTACT Tj . L' <br /> U Ili <br /> PROJECT CONTACT PHONE NO. /S Jl �j t]c� 10 I. <br /> k h <br /> Sample No. i Sa pie Type Sample Volume �~ <br /> Preservative <br /> JT7 -` IsJ 1, Requested Testing Program <br /> •' � � r G �„ �� �• ' Special instructions <br /> � <br /> cwIo OrIx< 01`j <br /> I! <br /> i� T - rj_ - � y F <br /> L� <br /> SST ,-` �, L '----- rr 41 �� ------ j <br /> CC 7F PIA 015 <br /> ------._ 2. <br /> f - <br /> TURNAROUND TIME REQUIRED: (Rush must be approved by the Laboratory Protect Manager.) OC LEVEL: <br /> Normal I " `, (Levels II and III subject to surcharge;project-specific requirements musi be � <br /> Rush (Subject to rush surcharge.) submitted to lag before beginning work.] <br /> if ill <br /> POWSLE HAZARD IIIDENTIFICA,TION: (Please indicate if sampte(s)are hazardous materials andJor suspected to contain high levels of hazardous substances.) Protect Speeitfc !, <br /> - Non hazard_ ' Flammable— <br /> Skin Irritant Highly Toxic ; <br /> SAMPLE DISPOSAUc (Please indicate , - Other f } <br /> dispasd"i'on�, nple foftowing analysis.Lab wi0 charge for packing, <br /> Return to Client \. 9.shipping.archive and disposal.) (Please Specify) <br /> Disposal ley Lz<b�^ __N Archive <br /> ^•,�� (Indicate number of months.) ' <br /> FOR LAB USE ONLY II <br /> Received by I . <br /> WHITE-Onp <br /> g. io accompany samples Date/Time (' <br /> ELLC eld c t. � <br /> a <br /> e <br /> _ 1 <br /> 34 <br /> kY_.. •moi.. .. <br />