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m Billing information: Alpha Name I�-tui" p ""tical, Inc. <br /> N Address 255 Glenda;, enue,Suite 21 <br /> Sparks,Nevada 89431-5778 Page# of. <br /> city.Stale,Zip Phone (775)355-1044 <br /> FA <br /> Phone Number Fax Fax (775)355.0406 Analyses Required ' <br /> Client Nome <br /> Loo/ f9JrC P.O.# Job# ' <br /> Address <br /> PWS# DWR# f <br /> o City,State,Zip w Phone# <br /> Fax# <br /> U) Time Date h ft* Otiice Use sampled by RepartAttenifun rl <br /> Sampled Sampled See Key Only EQ Tetaiandtype of O Z 1`°p <br /> MOW Lab ID Number containers t\_ O <br /> LOSample Description be low p t� vti <br /> 5-17 Q S/ —01 (ti�- REMARKS <br /> 2 5.17 11045 <br /> ° AllV-"T <br /> a <br /> ADDITIONAL INSTRUCTIONS: <br /> Q <br /> r <br /> 4WRelinquished <br /> Signatur <br /> a Print Name <br /> _ Company <br /> hate <br /> '/� .�U14� S�r✓7r Time <br /> � � 13fo <br /> y 5-17-00 7—L0 <br /> o Received by <br /> /Y <br /> m Relinqulshedby V; <br /> f� <br /> S f] <br /> r Received by <br /> *Key: AQ-Aqueous SO-Soil WA-Waste OT-Other <br /> R": L Lifer V Voa S Soil Jar O Orba T Tedfar 8 Brass <br /> MOTE: Samples are discarded 60 days after results are reported unless other ar ernenls are made. Hazardous sP-Plastic OT-Other <br /> amples will be rotur' <br /> of the above samples is applicable only to those samples received by the laboratory with this coc. The liability of the laboratory is limitedly the amount paid for the report, <br /> of or disposed of at client expense. The reportfor the analysis <br />