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= morn M M r = r = i g r <br /> Samples Collected From Which State? <br /> Billing r0 Alpha Analytical, Inc AZ_ CA_ NV WA <br /> Name �k �� 255 Glendale Avenue,Suite 21 1D OR_ OTHER Page# of <br /> Address Sparks Nevada 89431 5778 <br /> City Stata 71n ,& Phone (775)355-1044 <br /> Fax (775)355 0406 Analyses Required <br /> Phone I PRIMA ENVIRONMENTAL. — 1.� / <br /> / 11931 <br /> ciient r 10265 Old Placerville Rd., #15 PO * 44# Required aC leve!? <br /> AddresSacramento, CA 95827 EMailAddress 4u' ` <br /> r.q r u ►I/ ry <br /> ciry St PH: 916-363-8798 Phone# Fax a Y <br /> FAX, 916-363-8829 EDoiEDF?YES_ xo_ <br /> Time Date Matnx' Office Use Sa poToth and of <br /> Sampled 5 mpled See Key Only /�•`� r e r 1=,erd contai ers 12101791 ID# <br /> Below Lab ID Number Sample Descl�((ption TAT island "See below REMARKS <br /> ADDITIONAL INSTRUCTIONS <br /> Signature Print Name pp Company Date Time <br /> R1Z <br /> r QA.L)'� t4� 6r J <br /> Received <br /> O� t 30 <br /> Relmq <br /> Received bIUAA C-1 C1 <br /> Relinquished by ` a <br /> Received by <br /> 'Key AQ-Aqueous SO-Soil WA Waste OT-Other L-Liter V-Voa S Soil,far 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 Huth this coc The liability of the laboratory Is limited to the amount pard for the report <br />