Laserfiche WebLink
INTERNATIONAL 276003 <br /> TECHNOLOGY ' R/A Control No. <br /> ' CORPORATION,! REQUEST FOR ANALYSIS <br /> C/C Control No. <br /> PROJECT NAME ' - ►.-1F1 2C11 L n NC DATE SAMPLES SHIPPED 662 <br /> PROJECT NUMBER IGII1 j LAB DESTINATION o <br /> PROFIT CENTER NUMBER LABORATORY CONTACT r�1 r �< < i-Ic Lk , <br /> PROJECT MANAGER 1 y►J&)(Z_ SEND LAB REPORT TO <br /> BILL TO 7-1-1 co»°• 1I Z`OC; -Fhcl Isco :L <br /> �I�� F--AcNEco �yT=> M FlT�1 I r.�•E� , <br /> NCS C fa . DATE REPORT REQUIRED <br /> PURCHASE ORDER NO. PROJECT CONTACT w�fJrV <br /> ' 1 ,• � Imo: 3`� - �K)O <br /> PROJECT CONTACT PHONE NO. C I <br /> J i <br /> Sample No. Sample Type Sample Volume Preservative Requested Testing Program Special Instructiond, <br /> �- IL yz bC `rAe-_�L iL X <br /> 4Z1 tall, <br /> L/ ` <br /> TURNAROUND TIME REQUIRED: (Rush must be approved by the Laboratory Project Manager.) QC LEVEL- (Levels II and III subject to surcharge;project-specific requirements must be <br /> / submitted to lab before beginning work.) <br /> Normal ✓ Rush (Subject to rush surcharge.) 1 It 111 Project Specific <br /> POSSIBLE HAZARD IDENTIFICATION: (Please indicate if sample(s)are hazardous materials and/or suspected to contain high levels of hazardous substances.) <br /> Non-hazard ✓ 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,archive and disposal.) <br /> Return to Client Disposal by Lab Archive (Indicate number of months.) <br /> FOR LAB USE ONLY <br /> Received b A. Dote/Time <br /> • <br /> WHITE- Ito accompany samples <br /> 1 128A-10.85 <br /> ne <br /> 1YELl i• ._.. <br />