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Billing I on <br /> Name �1 �`t Alpha lyfical, Inc. <br /> � '- 255 Glendale Avenue,Suite 21 <br /> Address Sparks,Nevada 89431-5778 Page# of <br /> City,State,Zr Phone (775)355-1444 <br /> Phony Number it?' s ax y Fax (775)355-0406 Analyses Required <br /> Client Nanj&.r' <br /> �, PO Job# <br /> Address <br /> PWS# DWR# <br /> City State Zi ' <br /> Phone# Fax# <br /> Time Date MOffice Use ampletl bReportAnto <br /> Sampled Sampled SeeKey Only Total and type <br /> ` <br /> of <br /> containers <br /> i Below Lab IQ Number Sample Description ..See below <br /> 7 ��� O OJ�B O/ �.*� ' REMARKS <br /> 117 2— <br /> ADDITIONAL INSTRUCTIONS <br /> Y <br /> re Print Name <br /> Relinquish y Company Date Time <br /> Receivers b �A' `L GJ ! `�/��l 3L/ <br /> Relinquished by G` O t ! <br /> Received by ( li7n� V <br /> Relinquished �n n / 2 <br /> Received by <br /> `Key AQ-Aqueous 50 Soil WA-Waste OT-01her L Lifer V Voa 5-Sort Jar 0 Orbo T-Tedlar B Brass P-Plastic <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 chem ense The OT-Other <br /> of the above samples is applicable only to those samples received by the faboratory with this coo The liability of tha Iahnr%tn— 1—J.- P e report for the analvcic <br />