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cutting fo ton: Alpha An icat, Inc. <br /> �' 255 Glendal e,Suite 21 Page <br /> Name_ N ` 5 arks.Neva#914 778 <br /> Na P <br /> Address Phone (775)355-1044 Analyses Required <br /> City,State,Zip � ✓ Fax {775)355 0406 / <br /> Phone Number P.O.N/ }-� Fax Job R 4 <br /> Client Name i r l!/ f C7t7 7 'O� " J y- <br /> �J PWS p 4VJfl q <br /> Address <br /> Phone 9 Fax 9 <br /> city,State,Zip ` <br /> �+,p4 OMce Use Re aAttenton Total and typeoi <br /> Time Date pnly earrrainers REMA1Ii4S <br /> Saul t el Sampled 5Belo y Lab IQ Number Sampte Qascrtption Se <br /> .. 0w <br /> rV <br /> f � � <br /> YI✓ 3t a4 <br /> lti+c 140 Iim6 <br /> ADDITIONAL INSTRUCTIONS: <br /> Date Time <br /> ig lu Print Name CompanyC7 01 <br /> Reiirsquis d by MA t— ( Z Y—2 r <br /> Received by <br /> Reliaquishadby � � _r7Cf�� �� <br /> Relin>�>�ishedhy <br /> Received by <br /> *Key: AC!-Aqueous SO•Soil WA-Waste QT-Other ": L-Liter V-Vaa S-Soil Jar 0-Orbo T-Tedtar B-Brass P-Plastic OT-Other <br /> ent or <br /> r NOTE: Samples are discarded 60 days after results are reported unless other arrangement's coo, The!abili5 are made. ar at the laboratorydous samples l is limited t0 tl�be returned toe amount nt nlaidn#nrdrhaof apnln.rnt expense. The report for the analysis <br /> of the above samples is applicable only to those samples received by the laboratory with tht h+ <br /> I y <br />