Laserfiche WebLink
L+� 1L1�1 `[ til L U� � LJU1 L JLC ' JJLl ,�,.ntt �UUL UAIV . 11tiW MUM <br /> CLIENT CONTACT NAME ANALYSES nFOUESTED <br /> STI A IV OILDJ_ <br /> ADDRESS CITY STATE ZIP <br /> BILLING ADDRESS PO N <br /> PHONE N FAX PHONE SAMPLER(PRINT SIGN NAME) ! <br /> ! T S 2 REMARKS SAMPLE II <br /> DATE TIME CONTAINER CLIENT '+t <br /> SAMPLED SAMPLED MATRIX AMOUNTITYPE PRESERVATIVE SAMPLE DESCRIPTIONISITE or <br /> LAT?I GRAB C MP <br /> 67 <br /> Mwz <br /> 12-5S M ') 3 <br /> 5A 476 1700 A 0,4 <br /> �� j �r,.1 rC►nJ c, r��—r—i t'�2— 1.�ZL I� <br /> r <br /> I <br /> By submittal of sample(s),client agrees to abide by the Terms and Conditions set forth on the reverse of this document <br /> ,FPLINQUISHEPBY DATEITIME RECEIVED BY RELINQUISHED BY DATE(TIME RECEIVED BY <br /> 38 9 <br /> SHIPPING METHODISHIPPING N RECEIVED BY DATErrIME CONDITION <br /> y - - MATRIX AQ-Aqueous Nondrinking Waler Digesled Metals <br /> z TEINP jO �- SEALED N lHTACT S FE-Low R L s AqueauS Hondtinking Water Otgested Metals <br /> O r PR DW-Drinking Water, SL-Sod Sludge Solid AR-Art <br /> N REMARKS ! <br /> M FP-Free Product <br /> m F CONTAINER TYPES AL-Amber Lirer AOL-250 ml <br /> AR Amber AHL- 500 mL Amber PT-^^i(Plaslur) HG-Hall <br /> pIq Gallon(Plasuc) SJ-Soil Jar 04- CT BT -Brass <br /> a Tube VOA-40 mL VOA OTC-0 3 Conla-ner <br />