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„y „1..,1, Mlun: <br /> Name Nw "V►r�, Alpha AjOtical, Inc. <br /> Address 255 Glendnue,Suite 21 <br /> Sparks,Nevada 89431-5778 Page# of <br /> City,State,Zip /�L Phone775 <br /> { }355-1044 <br /> Phone Number. ` Fax -4530- Fax (775)355-0406 Analyses Required <br /> Client Nam 54/} <br /> Address ZV LA;,�0 <br /> r PWS# [7WR p �Lt^x-/ <br /> Gity,State,Zip <br /> Phone# Fax# � <br /> Time Date Ngo* office Use Sampled <br /> r LL ReportAttenf <br /> Sampled Sampled See Key Only Total and type of <br /> Below Lab ID Number containers <br /> Sample Description **See below REMARKS <br /> L)t-159 0r <br /> ley` � _ �� 05 Iia t3 t <br /> i <br /> ADDITIONAL INSTRUCTIONS: <br /> n ure Print Name <br /> Refinquis by Company Bate Time <br /> Receive cs�s !(i� •G-7 G j� <br /> Relinquished b � � .• ,� ,�`"�—�I �� 1� <br /> Received by t <br /> Relinquished <br /> Received by <br /> `Key: AD Aqueous SO Soil WA Waste OT Other L-Liter V Voa S-Soil Jar O-Orbo T Tedlar 8-Brass P-Plastic OT-Othor <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 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 />