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} � <br /> iI'ITERNA'CIONAL <br /> TECHNOLOGY r � <br /> CORPORATION REQUESTFOR ANALYSIS RIA Cartlml No 2 3 2 <br /> ry trol No. <br /> PROJECT NAMEC/C ConDATE SAMPLES SHIPPED <br /> L �� <br /> PROJECT NUMBER �I ' ' }' <br /> LAS DESTINATION <br /> PROFIT CENTER NUMBER <br /> r,,fy, <br /> PROJECT MANAGER LABORATORY CONTACT'� ��"� 7 rl•' f% <br /> SEND LAB REPORT TO i 1 r,, ° <br /> BILL TO1 t 1, , , „o ; a <br /> DATE REPORT REQUIRE t f <br /> PURCHASE ORDER NO. <br /> PROJECT CONTACT <br /> � �f•� 17•'F�1� <br /> PROJECT CONTACT PHONE NC, <br /> r <br /> Sample No. Sample Type Sample Volume ?resenrdt L ; <br /> _ ye <br /> 71- Requested Testing Program <br /> S g y <br /> TURNAROUND 77MEREQIJfRED; <br /> (Rush must be a proved by the Laboratory Pra,ect Manager.) OC LEVEL: (Levels II and 111 subject to sun �� �{ <br /> / ^i P <br /> i - hg wo p=oject•specific regyiremenl5 mus!be <br /> Normel �, suhmitied to lab before beginning Wort.l <br /> Rush {Suhjecl to- <br /> rush surcharge,) I <br /> 11 ISI Project Specific �� <br /> POSSIBLE HAZARD IpENTIFICATIOti: (Please indicaie if sample(s)are hazardous materials andlor suspecled to contain high Jevalsof hazardous substances.) <br /> 3ry 2t: <br /> Non-hazard�' _ Flammable <br /> Skin irritant H19htyToxit rtt t�,tir�-: <br /> 4MPLE 1]ISPpSAL: Other_ <br /> (Please indicate dispositicn of sample following to danalysis,Lab vnll charge shipping, . f <br /> 1 9 for P ackin 9, AAing,archive and disposal.) ( Spetiry) <br /> Return <br /> Di <br /> sposal try Lab - Archive : <br /> (lndfcste numbcrof months.) k 3 <br /> FOR ORB ONLY L ` <br /> Rxeived by 4 yt <br /> WHITE•Ori to f J^, Date/Time 1== <br /> aecomparry samples r, <br /> - ELLt:• seta - r <br /> i <br />