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Bill ingjnforgaLton Alpha lybcal, Inc11, <br /> J of <br /> Address . <br /> Name = W's V 255 Glen venue Suite 21 <br /> 3uy„« � ,� n� Sparks,N a 89431-5778 Page# <br /> Phone (775)355-1044 <br /> City,State,Zip �`` 'fir"-3 E�- a G �U Fax (775)355 5-1 Analyses Required <br /> Phone Num 62b) Q& ���Fax <br /> Chept X e P 1 PO # Job# T4 V_'� <br /> Address I PWS# DWR# J <br /> Ci ��G/ Phone# Fax# V tJ <br /> Time Date It ft* Office Use Sampled by ReyortAtlenUon Total and type of a( <br /> Sampled Sampled See Key Only M i C v`' containers t�[a �C <br /> Below Lab ID Number Sample Description SH Wow ✓ REMARKS <br /> 0331 yew-� <br /> U01 <br /> 06�q P'j <br /> �750 M <br /> a p6 ,4 V c w- 2 U x x <br /> ADDITIONAL INSTRUCTIONS <br /> Signature Print Name Company Date Time <br /> uish byi�� <br /> ceived by (V(2 f1 L M U 5 0-j <br /> Relinquished by <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 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 />