Laserfiche WebLink
{ <br /> r <br /> a _ <br /> f <br /> INTERNATIONAL ,� ,1 <br /> TECHNOLOGY � t 2.�J 3 4 <br /> CORPORATION _ ) REQUEST FOR ANALYSIS I "rt � I Control N a <br /> COR RIA <br /> C N <br /> Can <br /> P., PROJECT.[SAME �? �7 �i.� �t'��ti\ PATE SAMPLE SHIPPED <br /> PROJECT NUMBER �C)r���� < B DESTINAT! N <br /> r <br /> PROFIT CENTER NUMBER' LABORATORY CONTACT �' ell Ir <br /> PRO.IECT MANACER �''� �^J'1`^'�'' SEND LAS REPORT TO <br /> BILL TO _�- <br /> I <br /> JAG ^)►`� �)' DATE REPORT REQUIRED -✓ f �L1 7 <br /> T,. <br /> i PURCHASE ORDER NO. 2 ��7� -•,--•- PROJECT'CONTACT .rn virik <br /> PROJECT CONTACT PHONE NO. I)�� <br /> Sample No. Sample Sa e T Sample Volume Preservative <br /> P ill P YPe R nested Testin Program I <br /> po4 g rog Speaa instructions <br /> y <br /> �t. <br /> VSs ('`� 1S <br /> 5555- ; <br /> f. <br /> TU RNARGUND TIME REOUIRED: Lusb must ba approved by the Laborat P 'ect iAana er. OC LEVEL: Levels li and III su ecl to Burch r 'ecl s ifie r uirenrernr muorY rW 9 1 ( bI arge:P of P� e4 st be_ submitted to tab before beginning work.) <br /> Normal Rushr ` l�$�bject to rust S�ir�l(6�e t II 111 Project Specific <br /> {� ✓.-+ <br /> ? POSSIBLE HAZARD I NTIFICA IDN: {Please.ndicate if samples)are hazardous materials and/or suspected to contain high levels of hazardous substances.) <br /> 'Mon-hazard�!_ Ramnrafrk�_ Skin Irritant H?gMy Toxic Other <br /> (Please Specify) <br /> SAMPLE DISPOSAL: (P:ease indicate disposition of sample following analysis.Lab will charge for packing,shipping,archive and disposal.) <br /> ReturnEo Client �' I <br /> Disrosat by Lafs` Archive (Indlrate number of months.) <br /> i <br /> FOR V2 USEONLY �� <br /> RecehpedbY lT, DateMme ` <br /> WRITE:Ori, to accompany sampres — - 1MA-10'ss <br /> � P <br /> i <br /> L <br />