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Billing I dor n Alpha A Ical Inc Samples CoNected From Which State? "~ <br /> US E— AZ CA NV WA <br /> Name > 255 Glendale Avenue,Suite 21 ID OR OTHER <br /> Address Sparks Nevada 89431 5778 • <br /> City State,Zip P& ,Qva K Phone (775)355 1344 <br /> ---_J�7Fax (775)355 0406 ArlalySt?5 ReC(Ulred <br /> Phone Number 09554 <br /> ���J l�7Gylir� ax <br /> Client Name �i PO Jot)b 4 <br /> en �G�rr J (n Required OC Level <br /> Address EMailAddress `0 l ! II II! !V <br /> City State Zip �L `�� Phone Fax q <br /> T EDD/EDF?YES_ NO_ <br /> Time Date <br /> Matrix' Office Use Sampled by Report Attent �� Total and type of � N '� <br /> Sampled Sampled See Key Only containers J+h /j Global ID N <br /> Below Lab ID Number Sample Description TAT nered "See below ~ REMARKS <br /> dq3 Z° <br /> 11510tv , J 5--v x Y <br /> i <br /> ADDITIONAL INSTRUCTIONS. <br /> 5tgn re Print Name Company Date Time <br /> Relinquished b y! S /a C/3 <br /> Received v y <br /> 801 if ALPiIA <br /> Relinqws <br /> Received by t - ,r? , r <br /> Relinqurshed by N <br /> Received by <br /> 'Key AO Aqueous SO-Soil WA-Waste OT-Other L-biter 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 />