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Billing Infor ivn: Alpha ytical, Inc. <br /> Name r � L� A [ <br /> 255 Glend venue,Suite 21 <br /> Address 3330 cltti / Sparks,Nevada 89431-5778 Page# of <br /> City,State,Zip /r- Phone (775)355-1444 <br /> Phone Number Fax <br /> Fax (775)355-0406 Analyses Required <br /> Client Name . II P.O.# <br /> rI GK F%✓ Job# <br /> Z t2o) <br /> Address .G L1 <br /> PWS# DWR# <br /> City,Stale,Zip e--LL Phone t+ Fax# �V <br /> Time Date Mabt(* Office Use Sampled by(2 /I_i RepodAttention � - Total and type of <br /> Sampled Sampled see Key Only !__ containers <br /> Below Lab ID Number Sample Description "•See below REMARKS <br /> u �rz I r o —a I ALcv— V- Ip fC <br /> i <br /> ADDITIONAL INSTRUCTIONS: <br /> I <br /> Sign Print Name Company Date Time <br /> Relinquish y <br /> Receiv !r <br /> 6-y 3� <br /> Relinquished by <br /> Receivedby / 1I�7 � --r / —�;� <br /> .� ) / .�,� Al rf Q11 <br /> Relinquishe`y <br /> F <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.,,uve samples is applicable only to those samples received by the laboratory with this coc. The liability of the laboratory is limited to the amount raid for thR rRnnrt <br /> I <br />