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Billing f r€na an: Alpha Analytical, Inc. <br /> -� 255 Glen enue,Suite 21 Pae# of / <br /> ' <br /> Address L"s yrt�cC-�a- � Sparks,N a$9431-577$ <br /> Phone (775)355-1044 Analyses requited <br /> City,State,Zip <br /> Name " �, Fax (775)355-0406 x y ' <br /> Phone Number Fax <br /> Ghent Name w P.O.# J '7 <br /> Address PWS# DWR# N el <br /> ,rte <br /> City,slate,Zip Phone# Fax# +` ;•�] \J J_.A- <br /> * } Office Use Sampled by n�`� ReportAttention i Tolalandlypeof J 1��4 <br /> Time Date SeeKeyOnly 1 containers <br /> Sampled Sampled Lob ID Number Sample Description "See below REMARKS <br /> Below <br /> tFF- <br /> M <br /> ADDITIONAL INSTRUCTIONS: <br /> II ign Print Name Company Date• Time <br /> Relin fished by <br /> ceive <br /> Relinquished hY <br /> EReceived by � C a� ]-1 ,� jo <br /> quished <br /> Received by � <br /> `Key: AQ-Aqueous SO-Soil WA-Waste OT-Other `*: L-Liter V-Voa S-Soil,lar 0-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. j <br />