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Billing I Form , n: AIpha An Ical, Inc. <br /> Name �" ),k 255 Glendale Avenue,Suite 21 Page# of <br /> Address Sparks,Nevada 89431-5778 <br /> City,State,Zip 1''�^-0h� Phone (775)355-1044 <br /> �Fe�G Fax (775)355-0406 Analyses Required <br /> Phone Number ax <br /> Cilent Mer <br /> Address //VV PWS# DWR# <br /> City,State, � Phone N Fax# 2 9 <br /> ' Office Use Sampled L ReportAtlentio Total and type of � <br /> Time Date l) <br /> See Key Only �r � v� s;ontainers � � � <br /> Sampled Sampled Below Lab IDNumber Sample Description "Seebelow REMARKS JY ` <br /> -C) Al Ld- 1 a 6V P ,� ,L <br /> Kiv_ _dlS ✓ 1 <br /> ADDITIONAL. INSTRUCTIONS: <br /> a e Print Name I Company Date Time <br /> Relinquish y /L !fir J � 0 Z-2, <br /> Received f ryr y� i V 3 f "L <br /> Relinquished by <br /> Received by <br /> Relinquish b <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 f-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 analysts <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 />