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.,�: ,>,�. .. .. :. ,d,, .: :a, per.= ••. , ,�_ <br /> Blllingrinfor Qn: _ ' Alpha AAgytical, Inc' <br /> Name �S r� 255 GlendWenue,Suite 21 Page# of <br /> Address C4-,r ���--"� _ Sparks,Neva a 89431-5778 <br /> Phone (775)355-1044 <br /> City,State,Zi Fax (775)5)355 1 Analyses Requited <br /> Phone Num �=O�(Fax � i <br /> Client NameA P.O.# Job# �` <br /> 2067' 'v _ <br /> Address PWS# DWR# <br /> �• ,G �o X3.4 �- �� <br /> City,state,Zip� I Phone# Fax# <br /> �---•C>j E p 77 00 a 6Q <br /> Time Date matroP Office Use Sampled'b'yy Report enter Total and type of <br /> Sampled Sampled See Key Only G� /G- containers J <br /> Below LabIDNumber Sample Description "Seebelow 'V) REMARKS <br /> 14 <br /> ,6 tM r.-1- <br /> 2S mW Cl <br /> L-)- to s <br /> r <br /> ADDITIONAL INSTRUCTIONS: <br /> A <br /> Sig ature Print Name Company Date ) Time <br /> Re ed by <br /> R d by / rri - F-.t ` r o 12 S�D <br /> f <br /> Relis�quishetl by <br /> Received by <br /> Relinquished by <br /> Received by <br /> 'Key: AQ-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 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 /> I <br />