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rstiitng rntormatior3 Alpha lytical, Inc, <br /> Name _ V 255 Glen venue,Suite 21 Page# of <br /> Address .��_S�� C�✓ v—� ..�1�t1 t�l Sparks,N a 89431 5778 9 <br /> City,State,Zip Phone (775)355 1044 <br /> Phone NumbC.�7L G t aY iG __Guy Fax {775)355-0406 Analyses Required <br /> a �J U <br /> Client Name I PO # # j, ,LL <br /> Z4trl L- ID JL <br /> AddressPWS# DWR# 1 <br /> State Zi o7-7 6C <br /> CrtY <br /> Zip Phone# Fax <br /> a'TCly ! X <br /> Time Date Mabe' Office Use Sample ///C� ReportAttentio Total and typeot t]�N� �� v <br /> Sampled Sampled See Key Y containers �\ In <br /> Below LablDNumber Sample Description "See below \ REMARKS <br /> tztc `Y'Y -- 6 t,,a - <br /> Q r (kA <br /> Fla I <br /> ADDITIONAL INSTRUCTIONS <br /> Signature Pnnt Name Company Date Time <br /> e e y <br /> R eivedby W ��O �4 �r <br /> Relinquisshheyd by <br /> Re <br /> Relinquished by <br /> Received by <br /> "Sey 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 /> TE 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 /> Labove 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 />