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Billing Infor � � Samples Colle From which State? <br /> Alpha Analytical, Inc. , NV WA <br /> Name L �apZ ca <br /> 255 Glendale Avenue,Suite 21 / <br /> Address y Sparks,Nevada 89431-5778 ID OR OTHER Page f' of <br /> City,State,Zip ! Phone (775)355-1044 <br /> Phone Number Fax C Fax (775)355-10406 <br /> Analyses Required <br /> Client Nance � <br /> Y I tots ) 5t• Required OC Level? <br /> Address EMail Address ! y <br /> i 1 L r� N T 9, ( ,Qr it lr 111 ry <br /> City,State,Zip�q E r e C Phone!I I a r Ir _ LV <br /> t t 2r�1 S � 2 S% )1 'j�� �( EDD/FDF YES No_ <br /> Time Date Mabiz` ++pled by Report AttentionTatal and type of <br /> Sampled Sampled c+ob,rlDs <br /> Below tab ID Number ( effo Sample Description TRT Fnerea See lb�elarr 1`�, ! J� <br /> >Y ! REMARKS <br /> ` Q 0 I _ C _ V\/ 4� A LL <br /> V I r OQ � 4 Cl\r <br /> ��-- <br /> Nn <br /> iZ.'o p <br /> lz:l -2- <br /> "z:15 1 s P - -- - <br /> 17 5 ~- 3- M ( <br /> A <br /> - <br /> A - t S P3 Z <br /> ADDITIONAL INSTRUCTIpNS: i4L-( EG ,� C Ate`► le.S " I� -r✓L / �51d1-- 'htC <br /> Si nature Print Name Company Date Time <br /> Relinquished by � d C_ r 6 ; T' <br /> Received by CLQ s Ll <br /> Relinquished by 131 LTI <br /> Received by <br /> Relinquished by <br /> Received by <br /> `Key: AO-Aqueous SO-Soil WA-Waste OT-Other AR-Air "": L-Liter V-Voa S-Soil Jar 0-Orbo TTedlar B-Brass P-Plastic OT-Other <br /> NOTE: Samples are discarded 60 days atter 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 /> of 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 />