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6illitti An , <br /> atiori: Samples Collected From Which State? <br /> 9 +� Alpha lytical, Inc. AZ CA fC NV_ WA_ <br /> Name 7�3to v �_ 255 Glendale Avenue,Suite 21 !D OR— OTHER Page#_� <br /> Address c3�3t) PX Dom. 5+.,'T �S 0 Sparks,Nevada 89431-5778 -- -of-L-- <br /> City,State.Zip Cu!,ti.-t jpC Ca 'T (.rZ Phone (775)355.1044 <br /> Phone Number33-0 4 7A Laoy t=ax S30 1-71-1003` Fax {775)355-0406 Analyses Required -, 0 <br /> Client Name P.O.>k Job++ <br /> M S 19 1151p0 - e at,r-a Required QC Level? <br /> Address Entail Address <br /> city,State,Zip 11 !ll lY <br /> Phone Fax a ,, — <br /> Mat t1iCe .h. Sa dtyy. Re rtAttenti0r r V EDD/EDF7YE5� ND <br /> Time (}ale Total and type o, C <br /> Sampled Sampled See Key Cnly f+ `� °We �Oie4 containers Q In Glo6allU�TDCO7706 8 <br /> Below Lab ID Number Sample Description TAT Fuemd "See below REMARKS <br /> ARO,:SIV. OT DSDS t2A - 01 W.% C A !Fl F S ! i <br /> 10 ! 4 4 b-ja %/J,I.t,t 57-4'r <br /> Vv"'4 ,w t v-&i 4 ;z'i la- <br /> I <br /> ADDITIONAL INSTRUCTIONS: <br /> i <br /> 5i nature Print Name Company Date Time <br /> Reb-nquished � <br /> rik cm U. <br /> Receivedby t�E.O <br /> Relinqu"shed by <br /> Received by <br /> �izL�s 1a cc <br /> ReInquis^ea b} <br /> Received by - -- <br /> 'Key: AQ-Aqueous SO-Soil t'JA-waste OT-Other ': L-Liter V-'Joa S-Soil Jar 0-0rbo T-Tedtar S-Erass P-Pia t, O -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 ai cilFnt expense. The teeort ID,the analysis <br /> of the above samples is applicable cnly to those samples received by the laboratory with this coc. The liability et the laboratory is limited to the amount paid for the repo,! <br />