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Y"""" ti <br /> A <br /> Alpha A tical, Inc. <br /> Name � <br /> 255 Glendanue,Suite 21 � <br /> Addressil" )�f: #�j�, Sparks,Nev 89431 5778 Page# _of 031 -50 <br /> City,State,Zip �' % Phone (775)355 1044 <br /> Phone NumberFax - Fax (775)355-0406 Analyses Required <br /> Chant Name ` <br /> ,e j{ j PO #/1� Job# <br /> Address � r �,Z� <br /> r J60C rood, j\E{pPWS# pWR# <br /> City State ZipPhone# <br /> 1-4 61 -Phone # � <br /> Time Date Nth' Office Use Sampled by ReportAttemion Y Total and type of n. +� <br /> Sampled Sampled See Key OnlyS. ,F �,� I� — <br /> containers �� <br /> 5 Below Lab ID Number Sample Description ..See below <br /> �' REMARKS <br /> 15y, <br /> 15-50 5a ALi <br /> 1 -1SL --5b Com,-- <br /> �1 <br /> -3L' Cie 3 ;G � <br /> ALV <br /> t;- <br /> ADDITIONAL INSTRUCTIONS <br /> Sign a Print Name Com an <br /> Relinquished by p y Date Time <br /> LRecetved <br /> by <br /> hed ISA 13R� ! S-/�� <br /> Go <br /> by <br /> Relinquished by <br /> Received by <br /> 'Key AQ-Aqueous SO Soil WA-Waste OT-Other L-Liter V-Voa S-Soil,lar 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 analysts <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 />