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Name f m Alpha An cal, Inc <br /> 255 Glendaleue,Suite 21 r <br /> Address ��' ,� Sparks,Nevada 89431-5778 Page# of <br /> City,State Zip r –vim Phone (775)355 1044 r <br /> Phone Number,"Zx ���(. E'L max { `" f ,, �, e Fax (775)355 0406 Analyses Required <br /> Client!Name <br /> �5�/L q Jo <br /> Address v' 0, " ;7. <br /> PWS# DWR <br /> City State Zip PhoneFax <br /> # 4� <br /> (r <br /> Time Date Matnx" Office Use SampledbyS ' ReportAttention 7otalandtypeof <br /> Sampled Sampled See Key Only �f , ° t"t r <br /> Below Lab ID Number containers <br /> r r! <br /> JOU Sample Description See below <br /> f U or—� ,I���"�l�� ,w}��J�� � �� � M I REMARKS <br /> qt A \ " <br /> bit <br /> o5 C- Y <br /> ADDITIONAL INSTRUCTIONS <br /> r e Company Print Nam <br /> y . Date Time <br /> ReN3qurshe <br /> Receive f f y <br /> Aff' <br /> Relinquished by <br /> Received by <br /> �j jib( ��_ �� � ;•-;-�1� �� ` k l� "'�, � � i j l _� <br /> RelirrQmshed by <br /> Received by <br /> `Key AQ-Aqueous SO-Soil WA-Waste OT-Other L-Liter V Voa S-Sol!Jar 0 Orbo T-Tedlar B Brass P-Plastic OT-Other <br /> NOTE Samples are discarded 60 days after results are reporled unless other arrangements are made Hazardous samples will be returned to client or disposed of at client expense The report for the analysts <br /> of the above samples Is applicable only to those samples received by the laboratory with this coc The tiabildv of the lahnrgtnnr is limitpri to the amniint nasi fnr 1ho rani ri <br />