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Alpha ASI icEInc �,1 <br /> Billing Inform rt 255 Glendale Avenuea` Page# of <br /> Name �� "S �n Sparks,Nevada 8943Address - S' � WAMPhone (775)355 10 !� Analyses Required <br /> City,State,Zap 7 S Fax (775?355-04UfiL+ ✓`'" Y``� <br /> Phone Number Fax <br /> PO # Job k <br /> Cl�en1 Nart�e 7 �f i <br /> J P f PWS# 17WR p p� ✓� <br /> Address / E 7� OJ <br /> ! Phone# Fax# <br /> City State Zip <br /> ReppdA p ToW and type of w � <br /> • Office Use Sampled�y �r� coner5 REMARKS <br /> Time Date Only .. <br /> Sampled Sampled w Lab 10 Number Sample DescrtpUon <br /> le5-1 A Q <br /> I <br /> ADDITIONAL INSTRUCTIONS: <br /> Company Date Time <br /> Pent Name <br /> Signature <br /> Relinquished by <br /> o � ter ZZReceived tiY ap a jA M �R v�"''a^�`� ��� <br /> Relinquished by <br /> Received by <br /> Relinquished <br /> Received by <br /> SO-Soil WA Waste OT Other L-Luer V-Vaa S Soil Jar Q Orbo T-Tedlar B-Brass P-Plastic OT-Other <br /> "Key AQ Aqueous <br /> Samples are discarded 60 days after results are reported unless other arrangements <br /> �h this The liability of the laboratory s limited to the amount paid tot dthe of aeport client expense The report ort a analysis <br /> NOTE �� gni,,to th��P SamDles received by the laboratory <br />