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&.111+e19 +r+r�rirrdtron Alpha Analytical, Inc <br /> Name ''ice / <br /> t� 255 Glendale Avenue,Suite 21 Page# of 1 <br /> Address vytli Sparks,Nevada 89431 5778 <br /> City,State,Zip ��'�4 Phone {775}355 1044 <br /> Phone Number-�tV 4lr,WI7 2 Fax �Iy"67 blSfJ�f^ Fax {775)355 0446 Analyses Required <br /> Client NaPO # Job# <br /> Address <br /> PW5# DWR k NV I ` � V E�/I7�` I�� <br /> City Slate Zip Phone# Fax# 7�`��U <br /> Time Date 14�tKe Ofia�illse Sampled by �U/ Report gtteniion. f7 Total and type of �J � <br /> Sampled Sampled See Key y I� `J,I containers <br /> Below Lab ID Number Sample Description "See b ow J) REMARKS <br /> I <br /> ADDITIONAL INSTRUCTIONS. <br /> S ur Print Name Company Date Time <br /> Relinqursfte y <br /> Receive <br /> z7-C>2 z0 <br /> Relinquished y <br /> f <br /> !,qn <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 /> GNOTE Samples are discarded 60 days after results are reported unless other arrangements are maazardous samples will be returned to client or disposed of at client expense Th rt for the analysis <br /> of the ah wes as applicable only to those samples received by the laboratory with this coc bllity of the laboratory Is limited to the amount paid for the report <br />