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Billing Infor n: Alpha A�tical, Inc. <br /> Name r �! ._ —, 255 Glenda enue,Suite 21 Page# of <br /> Address ,' ,'%_ Sparks,Nevada 89431 5778 <br /> i'•" <br /> " Phone (775)355-1044 <br /> City,State,Zip <br /> Fax (775)355.0406 Analyses Required <br /> Phone Number ' ."rax <br /> Client Name P.O.# Job# <br /> Address PWS# DWR# <br /> City,State,Zip . Phone# Fax# <br /> Time Date Office use Sampled by Report Attention Totalandtypeof <br /> Sampled Sampled See Key Only — containers <br /> Below Lab ID Number Sample Description "Seebelmi REMARKS <br /> l; <br /> ADDITIONAL INSTRUCTIONS: <br /> • atur*� Print Name Company Date Time <br /> Relinquishgd6y _ <br /> ReceiveM/X71 r. <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by <br /> 'Key: AQ-Aqueous SO-Soil WA-Waste OT-Other ": L-Liter V-Voa S-Soil Jar O-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 />