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—,7 s, .....f....,... • . ... + fi0Je5W l i jJaJ. r Jr 40-1Q.00 <br /> Date•�' _ ' -- "� � R Q E R F O R W 0 R K Order# _— <br /> Time: I By: <br /> C L I E N T I <br /> } Contact Or <br /> Client:t��J. Ti � �r�' `' �1�1 --- Phone: (-------)e�y.�- I `� Representative: <br /> Address: r7 —T� ..:��_ `� City: _--_�-�L �r _�. %�� State: �CI lip: G �L' -------- <br /> � <br /> ��yy}} -} , <br /> I I L L I A 6 1�..� 1 i! �_ _ ------- ,I- -------- - Purchase Order --------------------- <br /> Bill To: Phone: <br /> _ ( ) ��i� � ��� Qr Contract Mo.: <br /> Address: �_ _ --- City: __- ------- State: Ctl ip: -- �7g ------ <br /> Payment: ;—; Cash f --_ ; Check f__._-- Bill '--' Other: -------------------------------___--- <br /> SAMPLE L 0 C A T 1 0 N I P R a J E C T 3 <br /> Address: _ City: __— C <br /> Cross --: - --__— State: lips _.__��--------- <br /> Street: U.S. Tank Removals: Number -„__„ Size __-- Gals Type ------- <br /> Copy To: NOTE: Attach Any Special Instructions Or Diagries As %ecessary. <br /> sCREOULINSI <br /> Sample: ;D One Time Only ;�; ileekly ;—; Moethly ;_; Quarterly 11_1 Other: Start late: 2-q I��l <br /> Results: 'Q1 Routine Silver Rush ;—; fiold Rush ' ' ` CUA <br /> ,1 <br /> i Tient= 11 Workdays S Workdays �,�—_—__—.,_,�_______--_ <br /> 2 Workdays <br /> Rate: ! List Price ! 1.5 x List (Needs tab Director's Approval)- 1 2 x List (Needs Lab Director's Approval) <br /> Lab 1.D. 1 Test Code Test Description/Method Comments List Price Discount Costs Incurred <br /> i <br /> Digestioaf Extraction, filtration, Or Any Other Special Handling Per Sample # s <br /> Field Service Charges <br /> Total Other Chargee f <br /> TOTAL 301 COST <br />