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Mame,4urrrtatton Alpha Analytical, Inc <br /> 255 Glen venue,Suite 21 • r ;+� <br /> Address es�:-��/ t s.-;L ,r`J/� Sparks Aa 89431 5778 Page# r "^ "of <br /> City,State,Zip L'y�cc .-�� r`C..��L G�w= Phone (775)355 1044 <br /> Phone Numbe ^% ��cir^ Fax LiE` .F.�.> Fax (775)355 0406 Analyses Required <br /> PO # Job# <br /> Address PWS# DWR# t'�" L <br /> City State,Zip Phone# Fax# I � <br /> Time Date Mato' Office Use Sam oledtw f Report�ttEntion <br /> See Ke Only 1 4 ��e___' 'Ll Total andfiners r <br /> Sampled S m�ple� y containers � <br /> Below Lab ID Number Sample Description "Seebelaw REMARKS <br /> Ed,�: 2— V � t� <br /> 6 V00, <br /> ADDITIONAL INSTRUCTIONS. <br /> Signature Print Name Company Date Time <br /> Relini d b / r <br /> L 00 <br /> Receive by C� <br /> Relinquished by <br /> Received b 7' <br /> Relinquished by <br /> Received by <br /> `Key AQ-Aqueous SQ 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 aooGe samples is applicable only to those samples received by the laboratory with this coc The lability of the laboratory is limited to the amount paid for the report <br />