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Alpha Analytical, Inc. <br /> o Name <br /> N Address 255 Glendale Avenue,Suite 21 <br /> Sparks,Nevada 89431-5778 Pa e# 2 of� <br /> City,State,Zip Phone (775)355.1044 <br /> Phone NumberFax Fax (775)355A406 Analyses,Required 01787,� 8 <br /> Client Nm <br /> a . P.O.Y Job Y <br /> Atltlress rnp <br /> PWSY DWRY' <br /> City,stele,ZIp Phone Y N (� O �' <br /> Time Date Asap• ONfce Use b R AhenYon `9 <br /> Sampled Samphd See Key Only .-.GtvvLu ti$e,.r TotalarxiNpeof 4 <br /> Below LablDNumberconlaims <br /> SampleDescdption ..Seebelow 5 }` 9' <br /> 61a� PW REMARKS <br /> hnw -I X x- <br /> "&° UP- 1 <br /> 1?�y M <br /> i120 NNW-3 1 <br /> tLaO_ —— 4- 4 <br /> N Mo W^s <br /> a <br /> 3 <br /> m <br /> JNOEI COC <br /> rn <br /> V <br /> L) <br /> N <br /> W <br /> O <br /> O - <br /> ADDITIONAL INSTRUCTIONS: <br /> ----------------- <br /> Signature Print Name <br /> Relinquished Company Date Time <br /> Receii o3 (s—!b <br /> G.CO�vt�of! 4yCt —S e rL <br /> Relinq �""`�"-�� L 5-10 <br /> Received by <br /> Relinquishadby <br /> Received by <br /> Key: AO-Aqueous SO-Sol WA-Waste OT-Other : L-Liter V-Voa S-Soil Jar O-Orbo TTedlar B-Brass P-Plastic OT-Other <br /> u NOTE: Samples are discarded 60 days after results are reported unless other arrangements are made. Hazardous samples vdll be returned to client or disposed of at client expense. The report for the analysit <br /> a of the above samples is applicable only to those samples received by the laboratory with this coo. The liability of the laboratory is limited to the amount paid for the report. <br /> 0 <br />