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Billing Information: Alpha Analytical, Inc. <br /> !Name 7`- US <br /> 255 Glendale Avenue,Saila 21 <br /> Address Sparks,Nevada 89431-5T78 Pa e tt of I `d <br /> City,State,Zip Phone (775)355-1044 a <br /> Phone Number Fax Fax (775)35s-0406 AnalySes Required <br /> Client Noma t <br /> 19 L� P.Q.# Job N <br /> Address PWS# owA t« Ll <br /> YDS <br /> City,State,Zip _ d Phone# Fax# <br /> Time Date Folft. Office Use Sampled by Reportritterdw TOtaland of x <br /> Sampled SampEed See Key Oniy t5P 0 1 t °0 <br /> Below Lab 10 Number Sample Oescripdon L See © ti <br /> A 5_ <br /> /7 0S/ W©j REMARKS <br /> r <br /> 'i �a�s <br /> 1 <br /> I <br />{ <br /> r <br /> ADDITIONAL INSTRUCTIONS: <br /> r Sig�atur Print Name Company <br /> Relinquished by Cate Time <br /> , 1w rr�4 -7- <br /> S-1 J3S <br /> Received by �-, <br /> n <br /> Relinquished by <br /> Received by <br /> Relinquished by <br /> a <br /> Received by <br /> i <br /> 1 `Kay: AQ-Aqueous SO Soil WA Waste OT Other L-Liter V-Voa S-Soil Jar O.Orbo T-Tedlar G-Brass P-Plastic OT-Other <br /> i !VOTE: 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 /> I� 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 raid for the report. <br /> i <br />