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Billing Infor a Fort: (L Alpha Analytical,Inc. samples Coils From Which Stale? ° t� <br /> Name CO, 255 Glendale Avenue,Suite 21 AZ CA NV WA / <br /> Address Sparks,Nevada 89431-5778 ID' OR OTHER Page� ! of <br /> City,State.Zip I Phone (775)355-1044 <br /> Phone Number Fax �`+ Fax (775)355-0406 Analyses Required <br /> Client Name I SIL ' +� P.o.# Job# ) fv Required 0 Level? <br /> Address Entail Address r } ! It !N !V <br /> i.3/ DG <br /> � {'- iG Cit_ . GVr''� c` ,'. <br /> City,State,2ip5+gf (C i� J �t�1� 5 Phone tF 24' 31 ax it _ i-Z S/ rti ��[ r. I I1, EDD/EOF?YES_ NO <br /> Tim sate 7MaUiz' Sampled by Report AttenSion Total and type at <br /> See cNttaineis <br /> Sampled Sampled Mow Eab ID Number ( u�n„r� Sample Description TATs See belay ' REMARKS <br /> V\/ LL S�lm�'c. ck <br /> 4 WL <br /> z• ` �' Z� <br /> , <br /> IZ:f2 yIV <br /> S - -3- <br /> id <br /> ADDITIONAL INSTRUCTIONS: �'�,t?7A ( E C �4 ' !S Z f +SES't�-�� q <br /> Si nature Print Name Company Date Time <br /> Rebriquished by 11 _V <br /> Received by <br /> Reiinquished by <br /> Received by { <br /> Relinquished by <br /> Received try <br /> 'Key; AO-Aqueous SO-Soil WA-Waste OT-Other AR-Air L-Liter V-Voa S-Soil Jar O-Orbs T Tedlar B-Brass P-Plastic OT-Other <br /> NOTE: Samples are discarded 80 days atter results are reported unless other arrangements are grade. 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 />