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G) <br /> w <br /> o Billing information: Alpha Analytical, Inc. <br /> $ Name—�, 255 Glendale Avenue,Suite 21 Z <br /> Address W703 <br /> O Sparks,Nevada 89431-5778 Pa e#_.�of <br /> city,State.Zip ll Phone (775)355.1044 <br /> Phone Number 1919'7M39-c.� axRr6(p Fax (775)355.0406 Analyses Required 017 7 4 <br /> CUM Name S � P.O.# Job# c � <br /> Address C Cf C <br /> PWS# DWR# 1A Z ��� 4 <br /> city,Stale,Zip Fex# >t <br /> PhoneN �® e[ <br /> TenaDate Mix' Office Uae Samp Ntent <br /> Sampled Sampled See Key Only - Z- Tofalandtypeot <br /> Below oDnwbem <br /> Sample Description Sceirsax ' <br /> REMARKS <br /> 12W _ a _ 2 <br /> IkZo — <br /> M — 4 <br /> -s <br /> 3 <br /> m <br /> i o LIN 001 .Gi•JD;qGN <br /> w <br /> LTT <br /> ADDITIONAL INSTRUCTIONS: <br /> Signature Print Name Company Date Time <br /> ReBnqulsicedb <br /> Receiv by <br /> Relinquishedby <br /> Receivedby <br /> Reil quishedby <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-01 her <br /> p 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 atclient expense. The report forthe analyst: <br /> g of the above samples is applicable only to those samples received by the laboratory with this cw_ The Ilar„ny of th^'" raton-'-"—iced tr " mom' forth n. <br />