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Billing lnf r Alpha A Ecal, Inc Samples <br /> Ales Co lecPd From Which State?WA— <br /> Name S 11V' 255 Glendale nue,Suite 21 ✓✓ <br /> lD OR_ OTHER Page 01 <br /> Address Sparks, Nevada 89431 5778 <br /> City State Zip f $L Phone (775)355-1044 <br /> Phone Number {6?271X,j Fax 46 Fax (775)355 0406 Analyses Required q Q <br /> Client Name PQ a Job 10998 <br /> 15iL� 3477 Required QC Level <br /> Address EMail Address <br /> Ll u C & �-' ew, � 51j, "4, I N ru ry <br /> 1 <br /> Cary State,Zip Phone# Fax p <br /> IEDDIEDF?YES NO_Time Date Matnx' Office Use Sampled by Report Attenuon �r}�,� 1� Total and type of ` (VSee Key Only '�'"'/i containers � arrDr <br /> Sampled Sampled F,a,u j/ <br /> Below <br /> l/ {1 Lab 10 Number Sample Descnption TAT ,na,� 'See behow REMARKS <br /> 1,58 11 / <br /> tijl -12 AQ 'Z cril- W -1—V <br /> 1- 3D41 -r v <br /> $ 9-IL Sv 5 4'yt 1— <br /> Cot -1-V <br /> 9;n 9-t A `1 G&V l — 5-7,j —7 V <br /> �,55 qz s CM --7 1t{-6 <br /> 0: iiR An V`-I- .43 3 1-7- <br /> ADDITIONAL INSTRUCTIONS <br /> Sigpiolturg, Print Name Company Date Time <br /> Relinquished b �5(0 t 4 E0✓ 1'f 3 <br /> Received by I1 r„—i3� <br /> Relinquished by �t "L <br /> e ed by <br /> Refrnquished by / l� <br /> Received by <br /> 'Key AQ-Aqueous SO Soil WA Waste OT-Other L-Liter V-`Joa 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 tenth this coc The liability of the laboratory is limited to the amount paid for the report <br />