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Billing Infnrr, n: <br /> Name ` ►� �fYv Alpha A tical, Inc. , <br /> 255 Glendale Avenue,Suite 21 <br /> Addresst�1,w�Gv°vti- k— Sparks,Nevada 89431-5778 Page# of <br /> City,Slate,Zip �' 4"AL Phone (775)355-1044 <br /> Phone Number'-LZG`L� Fax -d✓ �G!�v Fax (775)355-0406 Analyses Required <br /> Client Name / P.O.p Job# <br /> 21 <br /> Address PWS# DWR# ,k <br /> City,State,Zip ! Phone# Fax# �! �t �'/1V <br /> 'rime Date Matra* Office Use sampled by�J t jr L ReportAttention. Total and type of U }�V� � <br /> Sampled Sampled See Key Only !7 Y l containers <br /> Below Lab ID Number Sample Description *'Seetielow REMARKS <br /> 0�..11 7:.e <br /> Oil, � <br /> ADDITIONAL INSTRUCTIONS: <br /> Sic Print Name Company Date Time <br /> RelinquishedN111— <br /> 111 j �`? S ,0� <br /> Receive — /7 l�- <br /> Relinquished by <br /> E <br /> byh d <br /> 0 1[ .5v <br /> Faceived by <br /> *Key: AQ-Aqueous SO-Soil WA-Waste OT-Other *": L-Liter V-Voa S-Soil Jar 0-Orbo T-Tediar 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 lahnratnry wilt,thi¢rnr Tho fia Hit„„r th. <br />