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Billing Inf �r atton- Alpha Analytical, Inc. �` <br /> Name ���'✓� i �+°��✓� � �• t� 255 Glendale Avenue,Suite 21 Page# r of <br /> Address ,� l} Sparks,Nevada 89431-5778 <br /> City,State Zip s F� —� —.4 (=i4 0 � -,�: Phone (776)355 1044 <br /> Fax <br /> Phone Number c�2 6V fi(3C?ra _ 2 i"3 6 7 S 4:426Fax (775)355 0406 Analyses Required <br /> Client tame p y/�� _ p PO # Job# C <br /> Address PWS# DWR# 1j01, <br /> w � <br /> City State Zip � � � Phone# Fax# {-Z � <br /> Time Date` lViftR Office use Sam d y Report AnepWn TotalandWeot ),Q <br /> Sampled Sampled See Key Only ''�"—� containers C <br /> Below Lab ID Number Sample Description "Seebelow 'Zq- REMARKS <br /> 3 <br /> a <br /> i <br /> I <br /> ADDITIONAL INSTRUCTIONS: <br /> Signature / Print Name } Comnany Date Time <br /> Relinquished <br /> Received by <br /> Relinquish d by (' <br /> Received by <br /> Relinquished by <br /> Received by <br /> *Key A;,-Aqueol SO-Sod WA-Waste OT-Other '* L Liter V-Voa S-Sod Jar 0-Orbo T-Tedlar B-Brass P-Plastic OT-0ther <br /> NOTE Samples�scarded 60 days after results are reported unless other arrangements are made rdous samples will be returned to client or disposed of at client expense There r the analysis <br /> t f. _1__ _ __.__._I__ _ ___f__LI_ __I •_ L___ _____I__ ____ __I I. aL_ 1_L_ _ _._ it al_ _ ___ Yf tf f <br />