Laserfiche WebLink
k <br /> r_ <br /> INTERNATIONAL RIA Control No. 178642 <br /> TECHNOLOGY REQUEST FOR ANALYSIS r - <br /> CORPORATION CIC Control X10: i <br /> PROJECT NAME Tse 5- DATE SAMPLES SHIPPED <br /> f <br /> PRO JECT NUMBER `�I LAB OEST)NATION <br /> / -- <br /> >' <br /> `~ -- PROJECT MANAGER �!� �J /I F.' YrLABORATORY CONTACT <br /> JI BILL!TO �/ f Cd;.�� SEND LA13 REPORT TO L�n- / .-- <br /> `1f <br /> �• �' i 1 t ! 1r 3 <br /> n DATE 'a;i*PORT REQUIRED - } ` <br /> PURCHASE ORDER NO. r' ! ' F <br /> PROJECT CONTACT <br /> PROJECT CONTACT PHONE NO. / <br /> — <br /> �- Sample No_ Sample Type Sample Volume Preservative Requested Testing Program Special Instruclion: <br /> C7 L <br /> (��t'il C'iM+JJ t.,l .• S ,.•, ter' � �j� <br /> Cr , l r <br /> �l caSr,l4brl,.k. 1ir.l, •a . -r ,� <br /> TURNAROUND'"(IME REOU[RED: (Rush must be approved by the Project Manager") <br /> Normal ,X Rush (Subject to rush surcharge) <br /> POSSIBLE HAZARD IDENTIFICATION: (Please indicate it sample(s)are hazardous materials andlor suspected to Contain high levels of hazardous substances) „s <br /> Nonhaxard Skin Irritdnl Highly Toxic Other <br /> • ks <br /> .SAMPLE DISPOSAll (Pieria indicale dispos�t,on of sample following ani Lab willFharge for packing.shipping,end disposal.) B' <br /> ,51 T <br /> Refir"foclilerill Dlsporrl 4y Lrb <br /> t �rif <br /> FOR LAB USE ONLY Received BY_ rte— •OSx^ _ Oatemme <br /> Will-Original,to accompany samples I <br /> i <br /> YEL <br /> LOW-Field copv <br /> 3 i <br /> , <br /> k <br /> t <br /> i r• y <br /> r <br />