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Samples Collected From Which State? <br /> Billing Information: / Alpha Analytical, Inc. AZ� CA,) NV_ WA_ I <br /> Name Tr n /�^ "�-� T1✓' 255 Glendale Avenue,Suite 21 ID OR_ OTHER Page <br /> Address '3530 G� r- Pe d- ��D Sparks,Nevada 89431-5778 <br /> City,State,Zip G,-wa,#ro o% P C,. Q i Phone (775)355-1444 <br /> Fax (775)355-0406 Analyses Required 06021 <br /> Phone Number 010 67 '4100 Fax S3 V-9 7L`Loob <br /> Client Name P.O. Job M voL � Required 0 Level? <br /> LA. 14 ' S <br /> Address Entail Address �`�! 611 111 IV <br /> City,State,Zip Phone x Fax x a EoviEaF?2YES-! rio_ <br /> Matri:l` ONi a Use Sa by A;tenypn Total and type of !r crown fD 0 7770004 <br /> Time Date Onlya"rre � � containers (� 3 <br /> Sampled Sampled Bel lab t0 Number Sample Description TAT FroW REMARKS <br /> Pd7sna "See below j� <br /> I <br /> 01 l o T f S l c Y <br /> oks <br /> ati <br /> 6q67 at tt <br /> r � <br /> i <br /> I <br /> ADD.1 :TONAL INSTRUCTIONS: <br /> Signature Print Name Company hate Time <br /> Relinquished by %dC I(.. �aTe.. Gs V 1'lSr�S 1. o <br /> Received by ti C� <br /> Relinquishedbyby <br /> Relinquished by <br /> Received by <br /> 'Key: AQ-Aqueous SO-Soil WA-Waste OT-Other L-Liter V-Voa S-Soil Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br /> NOTE: Slims are discarded 60 days after results are reported unless other arrangements are maidAlWardous samples will be returned to client or disposed of at client expense. The repoWe analysis <br /> of the abaples is applicable only to those samples received by the laboratory with this coc. TlWility of the laboratory is limited to the amount paid for the report. <br />