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Bttimg In t' at�o , f — Alpha lytica#, Inc. <br /> Name " 255 Gler Avenue Suite 21 Page# of f 7 <br /> Address 6' 6�� i. . Sparks,Nevada 89431 5778 <br /> Cny State,Zip '� �� Z I Phone (775)355-1044 <br /> Phone Number Fax����` G��'� Fax (775)355-0406 Analyses Required <br /> V <br /> Clrent Na PO # J <br /> Iry l'y"4— <br /> Address PWS# DwR# IN, <br /> r vim! <br /> City State Zir Phone# Fax# l <br /> �� Office Use Sampled ,r Report Attention <br /> Time Date `LL ej( � Totalandtypeot r <br /> Sampled Sampled See Key only containers <br /> Below Lab IDNumber Sample Description "See below i REMARKS <br /> } �, s <br /> ,' ))t f.1✓.P - q <br /> A <br /> 68 <br /> ADDITIONAL INSTRUCTIONS <br /> 177 <br /> r <br /> 3 <br /> e Sim re Print Name Company Dale Time <br /> Relin ishedEy <br /> e <br /> Received b . <br /> Relinquishe by J" <br /> I <br /> R edAb <br /> Relinquished by <br /> Received by <br /> 'Key AQ-Aqueous SO-Soil WA-Waste OT Other `" L-Liter V Voa S Soil Jar O-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 />