Laserfiche WebLink
Yui <br /> I"TERNATIONAL <br /> TECHNOLOGY RIA Control No. 13 0 01 L% <br /> CORIsQRATION REQIF'ST FOR ANALYSIS 3 <br /> s pQn WGr NAME j �' C/Cl Control No. 50 1; <br /> DATE SAMPLES SHIPPED <br /> r PROJECT NUMBER Z _ LAB DESTINATION <br /> PROFIT CENTER NUMBER 3J I A <br /> LABORATORY CONTAG'T o1 N tq y�_1 <br /> PROJECT MANAGER 8 �✓ 1�_ SEND LAB REPoRr TO <br /> BILL TO <br /> !�of IV1($ Cps �} <br /> DATE REPORT REQUIRED L OJ <br /> PURCHASE ORDER No. —2- ?'t 99-9 - PROJECI CONTACT <br /> PROJECT CONTACT PHONE NO, 0 <br /> Sample No. mplo Typo Sample Volume Preservative <br /> (91 <br /> .SO 2+ 1 �t Requested Testing Program Special instructions <br /> 0 - <br /> 1 URNAAOUND TIMER ush must be approved by the Laboratory Project!lanager.) QC LEVEL: <br /> (Levels It aryl III subject to surcharge:proj"-specific roquiremenis must be <br /> Normal Rush (Subject to rush surcharge.) I J submitted to lab before beginning work.) <br /> Eli Project Speclflc <br /> POSSIBLE HAZARD IDENTIPI N: (Please indicate if samples)are hazardous mate <br /> rfats and/or sys <br /> petted to contain high levels of hazardous substances.) <br /> Non-hazard Flammable Skin irritant f ` <br /> Highly Toxic Other <br /> SAMPLE DISPOSAL: (Please indicate dis a following analysis.Lab will charge for packing,shipping,archive and disposal.) (Rinse Specify) <br /> Return to Client_ Dlspo by Lab Arehlve <br /> (Indicate number of months.) <br /> FOR LAB USE ONLY <br /> r j Received by <br /> Dale/7lme 0 <br /> WHITE-t,,,ginal,to accompany samples <br /> Y� r.Fle <br /> i <br /> 4-1 <br /> 1 <br /> .1 <br />