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Billingform tion f ' Alpha Analytical, Inc j <br /> Name v ✓W-V Yy- _ 255 Glendale Avenue Suite 21 Page# of / <br /> Address wl t✓O �^ Sparks,Nevada 89431 5778 <br /> Phone (775)355-1W <br /> Cay State,ap �` 4 Fax (T75)355 0406 Analyses Required <br /> Phone Number �Fax <br /> Clfenl Name ] PO # J�Wn W <br /> Address � 1 Kee G � i,�C PWS# 1 r�1 <br /> City Slat 11r��,J Pt[one# Fax# �y <br /> vwl <br /> 1W1Office Use S 6y ., / flepnrtAtlpnUort r <br /> Time flats S y Only r`r f L J N�G✓l roil cafta �ot (.3 (�l <br /> rs <br /> Sampled Sampled Haw tab 10 Number SamplaDescrip,11011 See ow <br /> REMARKS <br /> #47 a 2 . <br /> ADDITIONAL INSTRUCTIONS <br /> gna a Print Name Company Date Time <br /> TReceivedby <br /> 1 <br /> � I� 11 N 11-21-GV l3 3� <br /> i- �vG- r�a� � o��.�� vrr ✓�(�� 11-zr ,ac� 131 <br /> I_OCJ l 3 `F.� <br /> E&WnA <br /> � , FM USM A �a AV pQ f 3+ <br /> Rehngwshed by <br /> Received by cJrT l 1? JL7 l�c�S <br /> `Key AO-Aqueous SO-Soil WA-Waste OT-Other L Liter V-Voa S Sail Jar O 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 tha;4hnvnlAs n aoo(icable only to those samples received by the laboratory with this coc TOlity of the laboratory is limited to the amount paid for the report . <br />