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L <br /> Billing t rm tion n/ Alpha A tical, Inc <br /> Name efiv 255 Glenda nue Suite 21 <br /> Page # _._.._ of <br /> Address 3.� �.�. wry- �K a Sparks,Neva 89431-5778it (775)355 <br /> � f <br /> City,State,Zip Pi— c� Faxn(775)355 040644 Analyses Required 00670 <br /> , <br /> Phone NumberFax <br /> Client Name PO k Job# � <br /> Address PWS#r DWS# j <br /> �.i <br /> City,State,Zip r�j Phone# Fax N l f1 � 41� <br /> Time Date Matroc' OttOnlUse Sampledh,P�l,,fL,� ReportAttenhon � Totalandtypeof <br /> [Cry lrll � <br /> Sampled Sampled See Key Y containers <br /> Below Lab ID NumberSample Description "Seebdow REMARKS <br /> I <br /> ADDITIONAL INSTRUCTIONS <br /> at Frint Name Company Date Time <br /> Relin hed <br /> Receiv <br /> Relinquis by <br /> Received by <br /> Relinquished by <br /> Received by i <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 coo The liability of the laboratory is limited to the amount paid tot the report <br />