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Billing Information: Alpha Analytical Inc. Samples Collect d From Which State? r� ,- ^7�� <br /> Name S�f4�'US t'�� tyt,Q,.�g� AZ CA X NV WA O L `S' G J / <br /> 255 Glendale Avenue,Suite 21 <br /> Address 2125302 r S U Sparks,Nevada 89431-5778 ID OR_ OTHER <br /> Page I�of-:. <br /> City,State Zip C�.ne f2�., c..A C-A QS(o$Z Phone (775)355-1044 <br /> Phone Number 9'30 (a"ax Fax (775)355-0406 Analyses�2quired <br /> Client Name ppp <br /> Job N <br /> C i l b fc LG ro O —1 —6 n}}777p 0 Required OC Level? <br /> Address Email Address m •J ❑ III IV <br /> I $Fi S � S S41 C-Q-t1,.G S�z,�.,$i L V V <br /> City,State,Zip Phone u Fax k - V \ `/ <br /> ~� O to 5-so 1.-+- UO .[ EDD/EDF? YES n No_ <br /> Time Date Matrix Sampled by � � �ra ReportAnenlions Total and type of IU <br /> Sampled Sampled See Key `o containers GrODar tDM <br /> 06Below Lab ID Number Offoe Sample Description TAT Frem <br /> (use om) P p Fnie,� "See below REMARKS <br /> ryz }�z� w -o SWC- - SD rliA bX x 'x X <br /> ADDITIONAL INSTRUCTIONS: <br /> Signature Print Name Company Date Time <br /> Relinquished by ra Skf kJ �, v"A-/Ltlei <br /> r <br /> Received - a) ❑ <br /> Relinquishe - .� ... ^ –oI icio <br /> Receive �. I /D <br /> Relinquis y <br /> Received le <br /> 'Key: AO-Aqueous SO-Sail WA-Waste OT-Other AR-Air L-Liter Moa 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 Coe. The liability of the laboratory is limited to the amount paid for the report. <br />