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Billing Information: <br /> !� / AI}�h afytfcal, Inc. <br /> Name +�•! 255 GI Avenue,Suite 21 <br /> Address ( S arks ada 894 1- Page # of • _f <br /> P 3 5778 <br /> City,State,Zip r�li . Phone (775)355-1044 <br /> Phone Number W, f., L� ��ax %� r�-� ��" Fax (775)355 0406 Analyses Required <br /> Client Name <br /> FO # <br /> L-111511 f.,,� ; Joh 7 !G® L� ,a, <br /> Address sG4 PWS N DWR# 'T1••=-,5' <br /> City,State,Zip c Phone# Fax# <br /> TimeDate Ma* <br /> Office Use Sampled by / ReportAftentio Total and type of <br /> On <br /> k <br /> L <br /> Sampled Sampled See Key Y containers <br /> E Below Lab ID Humber Sample Description -See befow REMARKS <br /> I <br /> ADDITIONAL INSTRUCTIONS: <br /> -w re Print Name Company Date Time <br /> Refin uis b �l <br /> q C .� <br /> Recei , <br /> Relinquish by Y <br /> Received by -i Lf C't <br /> Relinquished by <br /> Received by <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 /> W the above 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 /> i <br />