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Name J + -"L . AlPhaAna! tical, Inc. <br /> ���r rv�"��' fq 255 Glenda nue,Suite 21 93148 Address 1� ,,11 �,, �r c ,cam S-ro Sparks,Nev 9431-5778 Page# OfS <br /> city,State,Zip o r,g Phone (775)355-1044 <br /> Phone Number�3 X26 76- - ce'3 Fax r5-3 cj j.�Zg Fax (775)355 0406 Analyses Required <br /> Client Name <br /> PO # <br /> Job# <br /> � '— T ,^vc +.c Z� 's��- I�LEr_'.� <br /> addressJZ e-3 '3- 1�b C o - A t <br /> PWS# DWR# <br /> u c/ i cti�� <br /> City State Zip i <br /> S� <br /> _ Phone# Fax# 14 r <br /> Time Date 6Bttnc' Office Use Sampled r - ,, RepodAttention <br /> Sampled Sampled See Key Only V. r�I `qtr„ `' V)'N� ,-, Total and typaof ! <br /> Below Lab ID Number Sample Description �'�See Wow ` �� 1� <br /> W <br /> f Is- s/,L �Q �tDSt�'t�S-0I �P ' pt- l-Z REMARKS <br /> � E <br /> %sr S7"V <br /> 1I 't6 � ✓ ✓ '� f ✓ ✓ <br /> ��- �fT O1 - I ' I--a ✓ ✓ ✓ ✓ <br /> 115-0 -51,z, AQ -(�3 CIPT 01 - 2-2- -T <br /> 7-d ✓ <br /> 13 `/� 5t. �S pTp1 - -32 1 - f ✓ 4� ✓ ✓ <br /> 13 3 S `�n� <br /> - S ✓: ✓ <br /> -�? )�a <br /> ,✓ t/ ✓ ✓ <br /> ADDITIONAL INSTRUCTIONS- <br /> Signature Print Name <br /> Relinquished by }- Company Date Time <br /> Received �'tTIA <br /> Rellnquis 1% 11-7-Ol <br /> Receive:db y <br /> Relinquished by <br /> Received by <br /> 'Key AQ Aqueous SO Soil WA-Waste OT-Other L-Liter V-Voa S-Sod 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 />