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Billing Inifltion: � Alph '-alytical, Inc. <br /> Name i'` . ws _w 255 Glen me Avenue,Suite 21 <br /> Address Gv a tp tax`. ct r! ,y?� Sparks,Nevada 89431-5778 Page# of-—� <br /> City,State,Zip CaN^e,d ,, -_, C­ Phone (775)355-1044 $ <br /> Phone Numbe x-30 774-9PO r Fax ;- 3r�6ZC bD�s Fax (775)355-0406 Analyses Required 4f' <br /> Client Name / a 2.ba <br /> P.O.# Job# <br /> Address u E' ✓ 7"QOG s�p f�\p�j <br /> PWS# SWR# <br /> City,State,Zip Phone If Fax# t <br /> Time Date MR** Office Use Sampled by �-�� ReportAftention (/ Total and type of <br /> See Key only 67ckoi"! "LzLt)it 1CA- <br /> Sampled Sampled containers <br /> Below LablDNumber Sample Description -Seebelow REMARKS <br /> pc"� `Y�5'rte VT <br /> W�9-i24 1"+14 <br /> ADDITIONAL INSTRUCTIONS: <br /> r Sigpature�.. Print Name Company P Y Cate Time <br /> Relinquished by <br /> Received by <br /> Relinquished bq <br /> Received by <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 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 con. The liahility of tha lahnratnn,is rrrnitorl to iha amni of nm;,A r,,.Fh a <br />