Laserfiche WebLink
P!YO <br /> M'k <br /> co �►r�ort IIV OF COST RECORD* Page 1 of <br /> Protect Name/No 'j4:I A— - Sa nPleS Shipment Date ? 1 `"-9 L� — gill to 5 -L <br /> Sample Team Membersz _ -- i <br /> Lab Destination <br /> Profit Center No 3 ��4 I�IC3 Lab Contact 9 11 Clow CAI4*' <br /> Project Manager4 Protect Contact/Phone ?� �`SI►��`�` <br /> Purchase Order Nos I`�?I � j t3 Report to to (PC,— <br /> _� <br /> Z _ Carrier/1Naybill No __ k - <br /> Required Report Date I - -- -- - <br /> ample 14 sample 15 hate�me 1 ContalnerI`8antpie 1 pre7R"ua!@tft <br /> 20 Number Qeece n/T • Collseted a Yalume servatTesting CandWon on 21 22 <br /> ram Ra t Aeeard No <br /> FS <br /> J31PC <br /> +)Z JbI <br /> f <br /> 4' L <br /> L <br /> AMR <br /> t( <br /> _ f <br /> I <br /> S ectal Instructions 23 , <br /> Possible Hard Identification, 24 Sample Disposal 25 - <br /> Nan-hezardJ��,.,�' Flammable 'J Stan jrrrtant ,,,1 Poison B I.,J Unknown IBJ Return to Client I ' L <br /> „� Disposal by Lab Ar c terve Inca, J <br /> Turnar re Tlri�e cared 26 pr' I evel 27 <br /> Normal l0 Rush `Rll�{-} F—U-H 2VS4 I%` <br /> I ,� II l it 111 I,� P:o act acrfic (s eaf I`___ _ <br /> 1 Relinquished b Date r f-I`T -9 1 Received b 2 -- - <br /> l9gnatura/Afidfawni — y Dafe <br /> Time13oo IS+gnetura/Affihnt,nn) M Time i <br /> 2 Relinquished by Date 2 Received by Date <br /> is ,ea,�/amil�r�nl Time ISigr>ReceivrdniiiM <br /> 3 Relinquished by Date _ _ 3 Received b <br /> ISignntura/AffiFetion) Time YIII! I LIP• <br /> Comments 29 G ._._, <br /> NERD SPACE AS$ENT , CONI�N <br /> WA Vlot I <br />