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Billing o ion: Alpha lytical, Inc. <br /> Name 255 Glendwenue,Suite 21 Page# of�• <br /> Address vJt Sparks,Nevada 89431-5778 ' <br /> City,State,Zip 1�G Phone (775)355-1044 <br /> Phone Number °li�f�' y� Fax (775)355-0406 Analyses Required ` <br /> Fax . _ �iL:Le r� $�kole3 t <br /> Client Name f , ��/ P.O.# Job# <br /> Address v <br /> PWS 1i DWR# <br /> City,State,Zip Phone# Fax <br /> 1 1 <br /> Time Date * Office Sampled by r/ f ReportAttenf r Tatalandtypeof <br /> Sampled Sampled See Key y `J�' day` containers <br /> Below tab ID Number Sample Description =•Seetd REMARKS <br /> oro - 01 <br /> i <br /> ADDITIONAL INSTRUCTIONS: <br /> e Print Name { <br /> Company Date Time <br /> Relinquish y � > <br /> RO�Z �r <br /> I y i <br /> Relinquished by <br /> Received by , <br /> Relinquish d by <br /> I ReceNed by <br /> .c <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 /> di the Owe 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 />