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f• � � f• � � it li• � i• � � � � f• i• i• � � <br /> BillingC formatio r — Alpha Analytical, Inc. Samples Collecjed From Which State? r <br /> Name P,1 ✓' 0r 0.x1 255 Glendale Avenue,Suite 21 AZ— CA NV_ WA _ <br /> Address I1 Z;� —ro'U Sparks,Nevada 89431-5778 ID OR—_ OTHER - page# i or <br /> City,State,Zip Iri n CA- fp Fax (775)355-0406 / <br /> PAnalyses Required <br /> Phone Number Fax <br /> Cy'gnitN <br /> MO P.O.# JobN irn i r <br /> Y� I�( Ca{ 1 <br /> 1.-Wv �1Lt. IfD�O-7 T'T"1 Required QC Level? <br /> %* \4&A 1V EMaii Addressr(UCICk Q 61 2M r-O \ 1/ <br /> ! fl 111 !V <br /> Phone <br /> 4441(3 � ("2-2--9120 <br /> EDOI EOF1 YES . NO <br /> a Matrix' Sampled WCa4 RepatPt�t 1 C4 A Total andlyped - c�11D# <br /> SampledP See Key IKC II''�l Salto <br /> cr•Gx Fue contairers <br /> Sampled Beim Lab ID Number (, I Sample Description TAT FAR ••Bee belay /� REMARKS <br /> food SoQI ID I - N(LS -0c00T0b 10- Z_S X X <br /> Al a �fical Sal iple RgecoZ <br /> N— <br /> em e;a:t<rP <br /> i <br /> ADDITIONAL INSTRUCTIONS: <br /> Sfg ure Print Name Company Date Time <br /> Relin ,rG - (,1�2/tA N1LL-- 6 'h 't�`OIAQW <br /> Received by _O <br /> Relinquished bi <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 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 /> 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 />