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Billingfor on Alphatical, Inc l <br /> Name k 255 Glenda enue,Suite 21 Page# of c <br /> Address Sparks,Nevada 89431-5778 <br /> City,State,Zi Phone (775)355-1044 Analyses Required <br /> y — Fax (775)355 0406 YR <br /> Phone Number � Fax �� Ajyr <br /> Client Nam PO # Job#:20192 /11 / v <br /> Z�,�., <br /> fel <br /> Address PWS# D # ,� <br /> City,Slate Zip <br /> + Phone# Fax# <br /> Office Use Sampled by (� ReportAltention l Total and type of <br /> Time Date See Key only 4 ✓" containers <br /> Sampled Sampled Below LablDNumber Sample Description "See Wow REMARKS <br /> ! <br /> 11-4, SWI �tV <br /> iU <br /> ADDITIONAL INSTRUCTIONS <br /> ure, <br /> Print Name Company Date Time <br /> Relinqulshe P,,, ,'Z 7`c7il <br /> FF <br /> Recely -9 r d 707 <br /> rro i <br /> Relinquished by <br /> Relinquished by <br /> Received by <br /> `Key AO-Aqueous SO-SO[[ 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 trade Hazardous samples will be returned to client or disposed of at client expense The report for the analysts <br /> r o,► ,,,o��r»nlnc is annhphlP nniv in ihnaP-,RmniaS rprpivPd by the laboratory with this coe The liability of the laboratory is limited to the amount pard for the report <br />