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csnnng in or — Alpha AIcal, Inc <br /> Named ry 1 � 255 Glenda* ue,Surte 21 <br /> Pae # of <br /> Address r (� 6er www, 7 KSparks, Nevada 89431-5778 9 <br /> 4 <br /> Gily,State,Zip fG Phone (775)355-1044 <br /> Phone Number Fax <br /> Fax (775)355 0406 Analyses Required <br /> b � ` '� ���'7�" <br /> Client Name PO N Job N <br /> r - j <br /> Address PWS p DWR N -+— <br /> /y�{� <br /> City,State Zip `�' / �Q Phone 0 Fax# `► <br /> Maim* Office Use Sampled RepartAltention <br /> Tataland eo1 <br /> Time Date tYp t <br /> Sampled Sampled See Key only containers <br /> Below LablDNumber Sample Description •`Sao below REMARKS <br /> ADDITIONAL INSTRUCTIONS <br /> Y <br /> re Print Name Company Date Time <br /> Retrshe 5-/7q jJC zO <br /> Received' y � l <br /> _UA aAl 0 FY-\�_.C' oVvLO �{ hG �$ 1{ (]t 09L0 <br /> Relinquished <br /> Received by <br /> 2&A0 L/-aftj6ah-\_r� QS1 lo) /0 <br /> Relinquished y <br /> Received by <br /> 'Key AQ-Aqueous SO-Soil WA-Waste OT Other L Liter V Voa S-Soil Jar 0 Orbo T Tedlar B-Brass P-Plaslic 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 />