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Billing Info r on Alphaytical, Inc <br /> Nine VIE P�� 255 Glen�enue,Suite 21 <br /> Page# of <br /> Address _��•A�"`a`n'� P. 2(t'_ tDd_ Sparks,Nevada 89431-5778 <br /> City,State,Zip r �* � � � C.4 Phone (775)355-1044 <br /> Phone Numbed X76 foo `1 Fac IMJ<� Fax (775)355-0406 Analyses Required <br /> Client PO # Job# 6— <br /> Address PWS# DWR# � <br /> City,State Zip Phone# Fax# p o?fid <br /> �. <br /> 1 A.� � <br /> Time Date ; <br /> Office Sample b /� Repo ntioion�, Total and type of �� �C�a�A <br /> Sampled Sampled See Key y �** oontainers Q <br /> below Lab ID Number Sample Description "Seebelow REMARKS <br /> �11463 AQ - � <br /> tW A01w - <br /> ADDITIONAL. INSTRUCTIONS' <br /> Signature Print Name Company Date Time <br /> Relinquished �t G �•-,� - fr�hI �/1-2 3 Gni y� <br /> Received by 2 2bL <br /> v �, <br /> Relinquished <br /> Received by <br /> Relinquished by <br /> Recerred by <br /> 'Key AO-Aqueous SO-Soll WA-Waste OT-Other L-Liter V-Voa S-Sod 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 />