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Billing Infor 'on Alpha jMlytical, Inc j <br /> o c, 255 Glen enue,Suite 21 Page# + of <br /> Address +a-Y -rev-3 r�SL�- CJS Sparks,Neaada 89431-5778 <br /> City,State,ZipPhone (775)355-1044 r <br /> Phone Numb�O (_)C-+ Gam( F �� 6c Fax (775)355-0406 Analyses Required ILI� tr <br /> Client Name rr� C� PO # Jap# ' ,i VZ6 91 <br /> ���fj¢1 <br /> Address PWS# DWR# 1 <br /> City State Zip Phone# Fax# <br /> tX y- �,11a14 Rf7 <br /> Time Date hA DP Office Use Sample � ReportAttention Tota4 and type of \� 7 <br /> Sampled Sampled See Key Only containers !� REMARKS <br /> Below Lab ID Number Sample Description "See below `\ <br /> itC? <br /> V-3 <br /> rT i i i i <br /> ADDITIONAL INSTRUCTIONS <br /> Signature , Print Name Company Date Time <br /> R ceivedby 0 f, 1(A � 1 r ��k: 10141 0z' jorj <br /> Gt <br /> Relinquished by <br /> Received by <br /> i <br /> Relinquished by <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 above samples is applicable only to those samples received bytthe laboratory with this coc The liability of the laboratory is limited to the amount paid for the report <br />