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Billing InjigWation AlplMnallytical, Inc <br /> Name "7 +v ►h!r' b v1 ,A w 255 GrMle Avenue,Suite 21 ! <br /> Address . .511 f'r. :yra c'1 ,�%� D� "r� Sparks,Nevada 89431-5778 Page# f of <br /> City,State,Zip C A Phone (775)355 1044 <br /> Phone Number r) 1-•-'L- Ivoo 1 Fax _�aO ;�6. GQC2, Fax (775)355 4406 Analyses Required <br /> Client Name PO # <br /> 10e'-, 1#_u� � Job# <br /> f — y I,tca- 0di3� <br /> Address � PWS# DWri#f4 I <br /> Ju, <br /> City,Stale Zip ra Ilk Phone# Fax# f� t <br /> a'�At S-C3 i e <br /> Time Date 11"U' Office Use Sampled by Report Atte tion typ <br /> Sam led Sam led See Key Only V+ 1,3 f.�6-rvyr.v F 1,,,,�r I a ,-s-to c� Total and <br /> mere f 1. <br /> p p Below tab 10 Number ` Sample Description *'�See below <br /> REMARKS <br /> A,-,- <br /> U07 /14111`/ OT t: y r X <br /> ADDITIONAL INSTRUCTIONS <br /> f� 01 <br /> f0gnaturePrint Name Com an <br /> Relinquished by t ' _ 'W p Date Time <br /> Received b <br /> y A''rJ` <br /> Relinquished b ` t <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 he 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 pard for the rpnnrt <br />