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1822195
<br /> V/Asbestos
<br /> NYL WALK-IN D Lead
<br /> t-vb4.1,t4L greilRt twotts SAMPLE SUBMITTAL FORM
<br /> D Mold
<br /> LANIATIV.miLtilleoti.111.4.4tr
<br /> D Other(specify)
<br /> ,--
<br /> Fit st -..51 . 41 Last -C11474T064/ Company _
<br /> Address __,,,,Q2412__:.__r6.4kteAr iii47:71,.
<br /> Celt '
<br /> Phone Z.06- '4a7,--.t.c3z,3
<br /> Project NamoNornbertoject tocation ____. .40.7- 3-490/4,47-1,4 ve
<br /> „
<br /> 6-v-x426_,Tr- 8,%.44, 7572 03
<br /> ' -7"-- -
<br /> Turn Around Time
<br /> Pricing 1.--Hr 2,44r 4-Hr 1-Day J 1 Hour lAsbeStos only
<br /> Asbestos 70,00 65,00 60.0D 7C10 :I 2 HoOrs(Lead only)
<br /> Lead N/A 7000 6000 4000 -I 4 Hours(Asbestos,Lead, & Mld)
<br /> Mold N/A N/A .105,00 82-50 U2-erHours(Asbestos, Lad, &Mold)
<br /> Total Number of Samples
<br /> , sample to 1 Description
<br /> A/R
<br /> 1---
<br /> '
<br /> _ 'tit 1 ty tt
<br /> _
<br /> - -'
<br /> '6, r leittze-r Le 12430F2 11142.4... .... .„„,
<br /> ,
<br /> 4k,
<br /> 6
<br /> i _.„ i t
<br /> rams ha, liuNt
<br /> 7 ; 1
<br /> 8 I i
<br /> - — _,.-
<br /> , ( C,-
<br /> 9 !. -
<br /> ,
<br /> „,
<br /> f‘o 44-14a1(
<br /> ,_____________
<br /> _ - — --
<br /> Pam Nante , Stgnawre Company Date lime
<br /> ` i I
<br /> Sampled oy i .: i T
<br /> _ 1 _
<br /> I 0:41r1
<br /> Relinquish by oifftLertlitiork-, S/fe`4,011 1 i i r ; ___.1:..____,.3f)r/t1
<br /> .,.
<br /> Office(he Only
<br /> Print Name . . . nwat _ Comparry Date Time
<br /> Received bY 1 fil-, .,--d-f,....P t. .4rLif"' '*--4. -#4-4,..kw--- 1 ,_ Alv....4-
<br /> Analyzed by I ... .
<br /> CaRed by i , I .. ,
<br /> Faxed/En-tail by t 1
<br /> _______
<br /> 4r08 Aurora Ave N,Seattle,WA 9E103 1 p 206,547,0100 1 f 206.634.1n6 1 www nvilabs.corri
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