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taming imo ion: wimples Coltec d From Which State <br /> Alhlytical Inc. <br /> Name P� ` �ti I� .',r ^M�y_n_}: ni 255 Glen Avenue,Suite 21 AZ-- CA NV_ INA - <br /> Address ?a 1: 4 •,rarer-, f?„s'r !`_ ;.. i u �� A ID OR` OTHER Page#__A of <br /> Sparks,Nevada 89431-5778 <br /> City,State,Zip Frrk qr;K; Phone 775 355-1044 <br /> „� ( 1 <br /> Phone Numbers=�� i'L6c g Fax (ti: 1,1k ; G�Jt, Fax (775)355-0406 Analyses Required ? lj F� <br /> Client Name P.O.N Job# <br /> }c.5#; _ } ►#eqU! OC Level? <br /> Address Entail Address i <br /> 111 1V <br /> City,State,Zip Phone Fax# Q �� <br /> s n S; <br /> Time Date P,4alrix' QHice Use Sampled by RgmriAttenrio�y F Total and type of EDD/EDF7 YES Ha_ <br /> Sampled Sampfed See Key <br /> Only r �c.s' i�: containers 1 ��' Nf Global to r <br /> Below Lat..ID Number Sample Description TAT F'erd a REMARKS <br /> rrrared "See below <br /> 'c S p Q(P 0 y Z7-O) /` lnf — <br /> Y 56. <br /> } - S <br /> Lf <br /> 74-7 <br /> IJ <br /> Sly , Sc —d /"� �✓- - 5 <br /> ADDITIONAL INSTRUCTIONS: <br /> Sig ature Print Name Company Date Time <br /> Relinquished by <br /> Received by <br /> Relinquished <br /> Received by I rMr <br /> Relinquished by r <br /> Received ty <br /> 'Key: AQ-Aqueous SO-Soil WA-Waste OT-Other '": L-Liter V-Voa S-Soil Jar 0-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 coc. The liability of the laboratory is limited to the amount paid for the report. <br />