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Billing Inform •� n. Alpha A ' tical, Inc. <br />� dame �' "h✓ <br /> 255 Glenda l ue,Suite 21 Page# of <br /> -3•� 7, r� Sparks,Neva a 89431-5778 <br /> Address JJ ►" Phone (775)355-1044 <br /> City,State,zip Fax (775)355-0406 Analyses Required rte.p <br /> Phone Number Fax <br /> Client Name P.O.# Job 4j — l y 1 a <br /> DWR# <br /> Addressi� <br /> 1� ((�� i_:-57- PWS# <br /> UG/L K..�'� Phone# Fax u t� <br /> City,State,Zip , <br /> Time Date Nva` Office Use Sampled r?y� 1` ReportAtteniiDn � ' T6tal and type 0l <br /> See Key only 17 containers �n _ REMARKS <br /> Sampled Sampled Below Lab iDNumber Sample0escription "See below �J <br /> A LAI A- <br /> ADDITIONAL INSTRUCTIONS: <br /> Print Name Company Date Time <br /> Si gfureI <br /> .2— � ., •� �_,. <br /> Hecei <br /> Relinquished by <br /> h <br /> Received by <br /> Relinquished by j <br /> Received by <br /> `Key: AQ-Aqueous SO-Soil WA-Waste OT-Other ": 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 />