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� ottttng rm tion: �- <br /> Aiha A tical, inc. • <br /> Name 255 Glendanue,Suite 21 Page# of <br /> Address Sparks,Neva 89431-5778 <br /> City,State,Zip. ra&V i fir- 64 Phone (775)355-1044 <br /> Phone Number W P1791 Fax V" ,� Fax (775)355-0406 Analyses Required <br /> Client Name <br /> P.O. <br /> Address PWS# DWR# ,' <br /> City,State,Zip [ Phone# Fax# <br /> ri <br /> Trme Mtk* DffOnliJse Sampled by ReportAtten' <br /> ��L �• Total and type of <br /> Sampled Sampled See Key y containers <br /> Below Lab 1DNumber Sample Description —Seebelow REMARKS- <br /> 77)2, <br /> EMARKS71 ova <br /> VC <br /> �by <br /> MWIt 5, � <br /> Mw 7 <br /> LVOAll <br /> --o� =✓ 4' <br /> ADDITIONAL INSTRUCTIONS: <br /> ur Print Name Company Date Time <br /> Relinquis d by <br /> Received by <br /> E•F7—c °tt 10 E SC r•c- <br /> Relinquished by g ( ���v <br /> Received by <br /> Relinquish , <br /> Received by <br /> *Key: AQ-Aqueous SO-Soil WA-Waste OT-Other *': L-Liter V-Voa S-Soil Jar O-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 onl y 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 />