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r' —valet— %,ueleciea t•rorri which Mate? <br /> !'rw �s F.1 01le G rt r�C'Tcll, I Alpha Analytical, to 21 Az^ CA V MV— WA <br /> Name 255 GI�Avenue,Suite 21 <br /> Address C �-a ro .t 1°�' p/ Sar C ,�5 p sparks, da e9431.577e r0 OR— OTHER # 1 of <br /> City.State, �p_ 'N a ie n P w+Y. Gc 9 SL 8 Z Phone (775)355-1044 <br /> Phone NumberS,5 L 719-400 Y Fax 0 4 -Laos Fax (775)355-0406 Analyses Required % _ <br /> Client Name P.O.# Job+� _ v y <br /> Address U $ A G Entail Address Required QC Level? <br /> !L <br /> City,State,Zip Phone aFax1 11 Ill IV <br /> Lai � Ccs n A3 <br /> EDD/EDF? YES k NO <br /> Time Date Matr.M' office use sa�p�d�`' n Attenran Total and type of 'Q p — <br /> Sacs�!ed 5arrgle� See Key Only lil �o 1�K � Gw✓1 Y_oeJ�4 Glbm io <br /> conla.ner5 � � TOG 07T�a t <br /> f o <br /> i1 8eiarr Lab l[}Number Sample Description TAT ,��e ed "See below REMARKS <br /> 11 Yro 3 -VT S 11<T.Ik N o 01 1j's 4 6 g ►9 <br /> lYS 0 Z Lt 3 02 6 5- # S s X. r <br /> I <br /> I <br /> ADDITIONAL INSTRUCTIONS: <br /> Signature Print Name Company Date Time <br /> Relinquished by S 72 3 30 <br /> Received by <br /> Relinquished by <br /> Received by1(— <br /> Relinquished by <br /> Received by <br /> *Key: AQ-Aqueous SO-Soil WA-Waste OT-Other '": L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic O7-Other <br /> NOTE: Samples are discarded 64 days after results are reported unless other arrangements are made. Hazardous samples will be retumed to client or disposed of at client expense. The report for the analvsis <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 far the report. <br />