Laserfiche WebLink
1 <br /> � I <br /> l� <br /> ti <br /> ,I INTERNATIONAL i <br /> TECHNOLOGY , <br /> CORPORATIONREQUEST FOR ANALYSIS RIA Control No. 9 5 9 Q <br /> PROJECT NAME _����[ a A} CIC Control No. — <br /> DATE SAMPLES SHIPPED <br /> PROJECT NUMBER �� G <br /> — LAB DESTINATION <br /> PROFIT CENTER NUMBER---__,� I _ LABORATORY CONTACT <br /> PROJECT MANAGER - <br /> -p � wNN SEND LAB REPORT TO y!1 <br /> BILL TO �.I —1 - <br /> {� ll <br /> s DATE REPORT REQUIRED <br /> PURCHASE ORDER NO. PROJECT CONTACT �/�/E __�T <br /> — l <br /> PROJECT CONTACT PHONE NO, <br /> al <br /> r !,Sample No. <br /> Sam. le Type <br /> Sa�m�ple Volume . Preservative <br /> S55-p2- 3 RequestedTestingProgram _ Special lnstructio_ns <br /> _ <br /> PN <br /> --- <br /> � r <br /> G IfT�x <br /> - _ - - -_ - <br /> SSS-�5`°L—So r <br /> 6—X ale <br /> ° I <br /> TURNAROUND TIME REOUIREI7: (Rush must be approved by the Laboratory Project Manager.) OC LEVEL: (Le vets 11 and t:i subject to surcharge;project-speed c requucme-Itsmustbe <br /> Normal^ Rush _ �subrnili ro lab before beginning work.) <br /> ($object to rush surcharge.) I p IU Project Specific—�. "! <br /> POSSIBLE HAZARD IDENTIFICATION: i <br /> (Please indicate iI sample(s)are hazardous materials and lor ssspect'Id to Contain high levels of hazardous substances-) ti <br /> More Ihanrd Flammable Skin Irritant_ <br /> Highly Toxic _— Other <br /> F,wPLE DISPOSAL: (Please indicate disposition of Sample following analysis.L:b will charge for packing sb F Dins,archive and disposal:, iPle,ac Specify) I <br /> Re '�:to Client Disposal by Lab ✓ Archive (indicate number of months.l <br /> FOR LAS USE ONLY <br /> Received by '' Dale/Time —–Y <br /> 1 <br /> WHITE Ons to accompany samp!es _ <br /> r <br /> eId ( J <br /> n <br /> _�t IDA, <br /> �I <br />