Laserfiche WebLink
Billing Info tion AlphaMlytical, Inc. . <br /> Name 1 ':0 ��`�` 255 Glen venue,Suite 21 Page# Of <br /> Address 1170 &"m^- Pti-M Sparks,Nevada 89431-5778 eV <br /> Phone (775)355-1044 <br /> City,State,Zi�*0�� 'X Px^ CA - Fax e (7 5)355 1 Analyses Required <br /> Phone Number , V0 Fax /° � �� ea <br /> Client Name PO <br /> Address PWS# nWR# <br /> City State Zip =� Phone# Fax# <br /> Time Date :K' <br /> daOffice Use Sampled b,, ReportAttent �7 Total and type of + <br /> Sampled Sampled See Key Onty containers <br /> Below Lab 11) Sample Description "Seebelow REMARKS <br /> } � <br /> ADDITIONAL. INSTRUCTIONS <br /> r r i s <br /> ,/ Signatu e �, (fPrint Mame Company Date Time <br /> Relinquished by � � ��r e"14 �0 ! IPA <br /> � <br /> Received by—/// <br /> I f <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> Received by <br /> 'Key AQ-Aqueous SO-Sol[ WA-Waste OT-Other L-Liter V-Voa S-Sod 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 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 />