Laserfiche WebLink
ED <br /> INTERNATIONAL 115822 <br /> CORPORATTION REQUEST FOR ANALYSIS `533 8 R/A Control No. <br /> C/C Control No. <br /> PROJECT NAMEDATE SAMPLES SHIPPED <br /> PROJECT NUMBER LAB DESTINATION SZ Fp c cL� <br /> PROJECT MANAGER kvA 9"C—Cp LABORATORY CONTACT 4^da,�c d�za iC <br /> BILL TO "s 1, 1"1 ncYc�D SEND LAB REPORT TO -' t 'V1L—tp <br /> PURCHASE ORDER NO. t O t LF DATE REPORT REQUIRED c �C'Ee•`o l^ �t �'� <br /> PROJECT CONTACT <br /> PROJECT CONTACT PHONE NO. b t�� <br /> lip <br /> Sample No. Sample TypeSample Volume Preservative Requested Testing Program Special Instructions <br /> Q[720 Sri L.5 <br /> LOci -() <br /> TURNAROUND TIME REOU18ED: (Rush must be approved by the Project Manager.) <br /> Normal Rush ✓ (Subject to rush surcharge) <br /> POSSIBLE HAZARD IDENTIFICATION: (Please indicate it sample(s)are hazardous materials and/or suspected to contain high levels of hazardous substances) <br /> Nonhazard Flammable Skin Irritant Highly Toxic Other LLu�`ti 0i,1 ti) <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 Dle e 1 by Lab <br /> FOR LAB USE ONLY <br /> Raealred By Dele/71me <br /> WHITE-Original,to accompany samples <br /> YELLOW-Field copy <br />