Laserfiche WebLink
­11 <br /> Billing Information � c A F: <br /> Alpha Ana cal, Inc _ ,.� <br /> Name � v 255 Glendale e,Suite 21 page# of 4 6 8 + <br /> Address vszt7�✓ r JL '/��Z Sparks,Nevada 431-577& - <br /> City,State Zi e-' �_) c Phone (775)355 1044 { <br /> Phone Numberi Fax �67E. rJ,� Fax (775)355 0406 Analyses Required <br /> Che me PO # Job# qq j <br /> Address PWS# DWR# I7-47— <br /> city <br /> 4 rf---- <br /> Crty state zip Phone p Fax# <br /> Time Ddte Ivift. Office Use Sampidpy L`y Rep G�{ Total and type of <br /> Sampled Sampled See Key v containers I r (J <br /> Below Lab ID Number Sample Description See bel J REMARKS <br /> 5la �C4- �� �..,-• � <br /> 0 <br /> i <br /> ADDITIONAL INSTRUCTIONS <br /> I <br /> I <br /> Signature Print Name Company Date Time <br /> Relit h by ` gaT�C^' L L� •1 ,7�`E o �( <br /> Receiv by US <br /> Relinquished b -------------------- <br /> Received by y � r- �}�y +, I/, e a// <br /> Relinquished by <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 />