Laserfiche WebLink
i <br /> •.z n k <br /> INTERVATIONALi <br /> RIA Control No. 230312 <br /> TECHNOLOGY <br /> CORPORATION REQUEST t`OI�ANALYSIS t <br /> r-., i. C/C Centro!No. <br /> T: PROJECT NAME . JT>�. C' m^ DATE SAMPLES SHIPPED Z <br /> PROJECC NUMBER - �.3-2 LAB DESTtNATlOAt rlA►ti•Q _ ` <br /> 4 <br /> PROFIT CENTER NUMBER. 4� LABORATORY CONTACT —��k t {!v �{/►O- r <br /> PROJECT MANAGER <r I^J' iti�� SEND LAR REPORT TO <br /> s E„ {{ <br /> BILL TO s it <br /> 1`'���'� ►� A DATE REPORT REQUIRED <br /> /V <br /> PURCHASE ti i, (j <br /> / `. <br /> PURCHASE ORDER NO. PROJECT CONTACTk. <br /> j PROJECT CONTACT PHONE NO. �I5 _ –9 1 <br /> Sample No. Sa rple Type Sample Volume Preservative Requested Testing Program Special Instructions <br /> 41 <br /> SST 4 - v) t ; <br /> 5-r_ ;ISTGxC)S�xv�J m riNi <br /> t,. <br /> TURNAROUND TIME REQUIRED: _ Rush must be approved by the L�_t o atory Project!tanager.) OC LEVEL: (Levels II and Ili subject to surcharge;project specific requirements must be ; <br /> submitted to tab before beginning work.) <br /> Normal Rush/, ` ) (Subject to rush surcV.arge.) 1 I) In Project Specific )a <br /> H <br /> POSSIBLE HAZARD IDENTIFICATION: _ (Please indicate if sample(s)are hazardous materials andfor suspected to contain high levels of hazardous substances.) , <br /> Non->sazard Rammable Skin Irritant _ Highly Toxic Other. <br /> (Pse—specify) i.. <br /> SAMPLE DISPOSAL' (Please indicate dispiisdion q <br /> \r pie following analysts.Lab will charge for packing,shipping,archive and disposal.) <br /> 1 <br /> Return to Merit Diaposal try Lab Archive t(Indicate number of months.) <br /> FOR LAB USE ONLY <br /> Received by • ' DateMme_�•<[ - [ <br /> WHITE-O ,o <br /> , <br /> • o accompany samples <br /> Q.......�ELL(I aid c[ _ -s i .. 1 r <br /> {II <br /> s <br /> x� <br /> t P <br />