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Billing I tto � ��, Alph alytical, Inc. <br /> Name 7 255 GI Avenue,Suite 21 Page # of <br /> Address G� ✓Z�L Sparks, ada 89431-5778 <br /> Phone (775)355-1044 '�/ <br /> City,State zi L �� 0:V 'y p�� Fax (775)355 0406 Analyses Requared / 084 <br /> O <br /> Phone Number Fax iw <br /> Client Name � � �'7�5 7G PO # Job# <br /> Address PWS# DWR# � ,^ � <br /> City State Zip 5)2z �+ Phone# Fax# \ `+ 1 <br /> / 'J JJti/ <br /> N [ , � <br /> Time Date * OttIceOn Usr, Sampled by /�� ReporiAttenUon -r] Total and type at �i�7UdZU`f <br /> ,� "� <br /> Sampled Sampled See Key Only ✓ ` containers <br /> Below Lab ID Number Sample Description "*See below REMARKS <br /> ADDITIONAL INSTRUCTIONS <br /> _ ur Print Name Company Date Time <br /> Relin ed by <br /> Received by fill. aP= 0� <br /> Relinquished b 1 <br /> Received by <br /> Relinquished by <br /> Received by <br /> *Key AQ-Aqueous SO-Soil WA-Waste OT-Other L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B Brass P Plastic OT-Other <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be returned to client or disposed of at client expense The report for the analysis <br /> lof the above samples is applicable only to those samples received by the laboratory with this coc The liability of the laboratory is limited to the amount paid for the report <br />