Laserfiche WebLink
INTERNATIONAL <br /> TECHNOLOGY REQUEST FOR ANALYSIS R/A Control No. <br /> CORPORATION C/C Control No. <br /> PROJECT NAME C3rP.ALiori tar,lc ase >Terzt DATE SAMPLES SHIPPED r„,r- <br /> PROJECT NUMBER —LLL"?n6l LAB DESTINATION <br /> PROJECT MANAGER J.A. SI.oss LABORATORY CONTACT <br /> BILL TO TTir0 r,'i c �� SEND LAB REPORT TO T•A.• "cs <br /> 1.515 Arztold Drive Lm ... n,,;',•,R..,,.� i.:; r r; <br /> 11artinez, CA 94553 <br /> PURCHASE ORDER NO. DATE REPORT REQUIRED <br /> PROJECT CONTACT J.�? '(t C r. n R•, ; <br /> PROJECT CONTACT PHONE NO. <br /> Sample No. Sample Type Sample Volume Preservative Requested Testing Program Special Instructions <br /> 4-L OR <br /> r <br /> , J-- r° <br /> 16. <br /> r <br /> TURNAROUND TIME REQUIRED:,- (Rush must be approved by the Project Manager.) <br /> r } Normal X Rush (Subject to rush surcharge) <br /> POSSIBLE HAZARD IDENTIFICATION: (Please indicate if sample(s) are hazardous materials and/or suspected to contain high levels of hazardous substances) <br /> Nonhazard Flammable' Skin Irritant Highly Toxic Other <br /> (Please Specify) <br /> SAMPLE DISPOSAL: (Please indicate disposition of sample following analysis.Lab will charge for packing,shipping,and disposal.) <br /> Return to Client Disposal by Lab <br /> L'n�OCt 8£;er <br /> FOR LAB USE ONLY <br /> Received By Date/Time <br /> WHITE-Original,to accompany samples <br /> YELLOW-Field copy <br />