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Namet9 t 1_0 attan r Alpha An cal, Inc. <br /> r +�' 255 Glendale e,Suite 21 • <br /> Ah <br /> Address L 333 0 �� Qq�rp� Sparks,Neva 9431-5778 Page# of I ` <br /> City,State zip C.R M c!RA N r �� ���56,69 Phone (775)355-1044 <br /> Phone Number VQ 694 bqt Fax X30 f,00�' Fax (775)355-0406 Analyses Required 07990 <br /> Client t3ame <br /> -7oea U_V CKw P LAZA Pa # �a�# <br /> Address 15'6 0 O S. 14 AELAr'o sin PWS# DWA# <br /> City State ZipPh # Fax# P <br /> LA7 14 R.o P , CA one <br /> Time Date kbtm* Office Use Sampled by Report Attentionk x <br /> O <br /> Sampled Sampled See Key only M M0! ^' $. Cft�ff~t� Totalandtypeof �� t <br /> containers a <br /> Below Lab ID Number Sample Description ••SeebeJpy� �' REMARKS <br /> =030 b f4(�i A0., `P��0�t 1c02-01 w-I <br /> 2,e+ <br /> _H0 <br /> V e <br /> FST <br /> ADDITIONAL INSTRUCTIONS. <br /> Signat re Print Name Company Date Time <br /> Relinquished by � f i �ftClFn! NP't*WV $7+�V� �J , t: ��f�4 J3'30 kA <br /> Received by <br /> Relroqulshedby <br /> =ece'vedy <br /> Relinquished by <br /> Lon <br /> Received by <br /> 'Key AO-Aqueous SO Sol[ WA-Waste OT-Other "' L-Liter V-Voa S-Solt 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 />