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'6 Billin or tion: Alpha An ical, Inc. { <br /> Name '�k F:�1✓` I <br /> 255 Glendale e,Suite 21 1f t <br /> Nevada-'99431-5778Page 1; o{ ' <br /> Address Sparks, <br /> City,State,Zip � ' Phone (775)355-1044 <br /> Fax (775)355-0406 Analyses Required <br /> Phone Number_7 'i G� 1 Fax 2 t <br /> Client Name; j��/� ?""�' P.O.# dgp,i{� `� <br /> Address {/ rJ a PWS# D�W(R# <br /> City,State,Zip Phone# Fax# <br /> Time Date Mft* Office Use Sampled 1F:dj� Report Attention Totalandtypeof <br /> Sampled Sampled See Key y containers i <br /> Below Lab ID Number Sample Description "See below <br /> REMARKS <br /> WV <br /> b5 <br /> -09- <br /> ADDITIONAL <br /> -0`fiADDITIONAL* INSTRUCTIONS: <br /> re , Print Name Company Date Time <br /> Relinquis y <br /> Received y '/ ,� // �° <br /> / 7 / F <br /> 11 (? Gam✓ f ' _ 3'�� <br /> Relinquished by <br /> Received by 6 . 3 i <br /> Relinquished by <br /> Received by <br /> i <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 fie 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 />