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rsttung snrorma ion: Alpha Analytical, Inc. <br /> Names !1 G.L�� 255 G! Avenue,Suite 21 <br /> 376 <br /> Address v y a{'L SparksWada 89431-5778 Page# of_ <br /> City,State,Zip Phone (775)355-1044 <br /> Phone Number �( L6'L�/ Fax (� f7�jFax (775)355-0406 Analyses Required o 8 <br /> Client Name PO # <br /> S 6� j � . <br /> Address 747jq <br /> PWS# bWA# <br /> 'a <br /> City,State,Zip i Phone# <br /> Fax 7 �f Time Date Office lJse 5ampled6y /I/ ReportAttentio Toialand �" <br /> Sampled Sampled See Key Onlyi !7 ✓l_ � type of <br /> Below Lab tD Numbercontainers <br /> Sample Description '`See below <br /> jy 10-zti p`� — REMARKS <br /> rJ7.ZV <br /> r , <br /> I� <br /> it <br /> II <br /> I lj <br /> it <br /> l: <br /> i <br /> II <br /> ADDITIONAL INSTRUCTIONS: <br /> -'� atu Print Name <br /> Relinquishe / Company Date Time <br /> Receive <br /> Relinquished by <br /> I <br /> :�Receivedby����� <br /> Relinquished by l I id 21 l� <br /> Received by IIEEE <br /> *Key: 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 /> 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 11 only to those samples received by the laboratory with this coc. The liability of the laboratory is limited to the ammint nnirf tnr tha.om, 4 <br /> i <br />