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0 1111111111111111OM IMP, SAISLLISIIAMF MITO !" 111111 Mil Q ttffigdral /OP <br /> nossmiximorn • SAMPLERS(signature) <br /> 7. <br /> .fge 4 o all <br /> Send'Report To r2)�( t'1_'erEk _ ,t TURNAROUND TIME <br /> p C'', �—c '77�—.S 1 PROJECTe PO# jRUSdard(2 Weeks) <br /> Company E �.�� � 0 RUSH <br /> _ ]/ ! Rush charges authorized by. <br /> Address I t� }� y, KEvgDtSRZlk- SAMPLE DISPOSAL. <br /> /L�i / REMARKS <br /> City, State, Z1P . DC,f ��-� - ` to i? ,�,,11, j� Get F132 ,52.--- <br /> Phone l9'YSisposo after 3Q days <br /> // -cdV S S(' ' • 0 Return.samples <br /> # L 9 2?'?i /Fax#�)37a7= 7""'. n Will call with instructions <br /> ANALYSES REQUESTED • <br /> m wo O o4 • <br /> Lab late Time #of M �, . >. �• <br /> Sample II) Sample Type rR ,� a = �, Notes <br /> ID Saipled Sampled containers X U CJ <br /> F.:: E...a: 6-4. >0 E. .--P...., .. <br /> 63-0 A'_G 001 $-' i( • _S-- �E.15.--://5-..-3 62) • <br /> • <br /> ' - e '--VS—,5--- h-e 9;027 _.57- X A -X • <br /> , S-42 E iZ-23 ..S— X <br /> 05- y.2,53, --12129 <br /> o V <br /> '" 31s-� A-C if:try,` s k , . <br /> 1i5 '-3( 3 a2 A E 2%lS" Ste` )C /4 )4 <br /> - E-8-3/s'-cs— °A41.e- • A" - a flio . 5-- '. --: elo <br /> Ei /S--a`Z 'A.6 V S.137 , 5 )4 . <br /> Friedman&Jiruya, Inc. . S GNATURE PRINT NAME COMPANY . DAT • TIME <br /> 3012 16th Avenue West Rclinqui• ed h. <br /> - - . r;hk PETIZ, . A-05 i 01/41 .9'isi- <br /> Seattle, WA 98119-1029 Re! ' M.I'c ko,e..l.E- <A 1 FC e L • . 1 <br /> Ph. (206) 285-8282 Relinquished b: 5"'. . • <br /> • • Sauipl c. elaat-, Q . <br /> Fa.t (lUG)l8,?-5044 Received by: '... <br /> roxMs\coc\coc.noc <br /> S Hnpict<1% . ud at- 'L • <br />