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ED <br /> INTERNATIONAL Ll / 1 41 O YtU 17 8 5 8 4 <br /> TECHNOLOGY REQUEST FOR ANALYSIS R/A Control No. 7 8 5 <br /> CORPORATION C/C Control No. Q <br /> PROJECT NAMEDATE SAMPLES SHIPPED 1 l 11.I q 1 <br /> PROJECT NUMBER 140RQ7 _Z LAB DESTINATION <br /> PROJECT MANAGER LABORATORY CONTACT <br /> BILL TO45�S�n01�9--(,0+��{ I.�n� SEND LAB REPORT TO <br /> tvtr� ck 9455 4585 <br /> MTS C4 2�4 a--S <br /> PURCHASE ORDER NO. DATE REPORT REQUIRED 1111-7 I-} <br /> PROJECT CONTACT rj. M ,I`S <br /> PROJECT CONTACT PHONE NO. 64 IS ) 3`lZ Ion <br /> Sample No. Sample Type Sample Volume Preservative Requested Testing Program Special Instructions <br /> Q I F • 1Y. (7 i '$TG v -ro+cy i f e+1 t <br /> GZA ZAJr <br /> o3A <br /> 00 coyz--I l invh l <br /> 05-1" <br /> roc, <br /> 04P" It <br /> b T� <br /> 0-1A <br /> OgP` 1\ P 7- <br /> TURNAROUND TIME REQUIRED: (Rush must be approved by the Project Manager.) <br /> Normal Rush._V (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 IV 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 /> FOR LAB USE ONLY <br /> Received By A4 Date/Timet <br /> WHITE-Original,to accompany samples <br /> YELLOW-Field copy <br />