Laserfiche WebLink
r-I'l rill <br /> issil <br /> WLABORATORIES <br /> A N AL Y T [ C A L �� l Com',.-20000so_ 25 os�z�i2o�t, ��DEL-TECH SV 'rA AnalYSes Reques <br /> C 1- Standard Chain of Ctustc�cl3 <br /> 1-i1•i Staltislatl� S[rec°[ 1=re�nE,, C:;1 s)3-n(,-Ir;2.1Pre-Lp�n ID#. X26(]25 <br /> I irP)) FAX 48;-6,l <br /> Rc(I(Icstc[� flltalr�rs <br /> RrlHrrl AlIr r: <br /> V ` I'hnur <br /> Addre++ <br /> 1'ndnl.{un r ur Irl <br /> IA\ <br /> City,$tale,Zip <br /> <l clrrn <br /> IAB,bAc only 5a:n�lctl h}': <br /> "X. Dale Timc <br /> ('.urtlulcnl nr <br /> '.1ye r Saneplctl Sam�lrcl R, Clalir, [;Wile <br /> •-r Cos. •tmplc l)racril,linn/Ltrrallnn <br /> 9,11D :11 'ills <br /> { I <br /> Z, Z n <br /> ' <br /> J <br /> i <br /> �G? <br /> r S, <br /> Matrix 41ie:1.-Liquid S.Saud G-(l <br /> AdtlRirrn:d I1,Icr+: ,\ddiNrrnal Srnkr+.►ulirnr-hcd <br /> Type of Ilaxardi,�+incinlcd with Farnplc.: Ru+h Priority! <br /> z <br /> 1 2 else 1,1.,t. s It;ry. 1P>,yment Rmelved vi <br /> t i ff< Dara parkaplr:1�•vrl 11,RI or It'frinic rnn,) IIh bellvery <br /> bhp_Amount, <br /> I-1'u numl r.Laln of f:rr.gady •��IniUrtli _ <br /> i ISIRuanrrrl Nit'etpt�, _ <br /> Signature _ <br /> Prins Manic <br /> RterM1ed t RNlnquhhed hr; (arenlranl batt <br /> liner <br /> Rtce s /icelinquiqrsed for: <br /> Recrired r R[inqul+hrd hve <br /> R el I for Lnhnrn •r <br /> Nolke:Payment11112for i mon eS randE,ed as nOled haf sin ern QV0,in VIII wirlrin�0 ll S Ilam whnn irr+oicn If nos in pair),atrnnnl halance5;ylr!rlPPmnr1 rlalin ifnn <br /> eulaled al, I!Q";pe+month. 118% et annum.BSK 6 11ssoclsges 96,1111 bill Y l 7 I bnllr.Iry�I1I I)lIAIICPi ,fP 5lIIr P <br /> or olheraiee The person signing ler the Chir IVCompeny PxrrP9ily ArlrnnwIortq PS Ilial rrll pr pn'IellrlrlllPlll r•ILrpllr il4,{Dili nI CnIIPC EIi)Ili,Ins;=IlrliriU allnrll InP. fl Io}nQrIR1I CPf YIr; <br /> -y aril PilhPi Ihn Clinnl rr anllrndirid agPnl nI Via r)innl nye inr nn nrl prVvr 1n rn in hhgAlinlr va ialhnr rOnrl ISP P:r4 h411hiq�h•.rg.q W111 a lCrorl'f.11 <br /> rf by Ii r�}gmv„I- ,nlllnrnmd n nrrnnricn <br />