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Billing o ion: / Alpha A icaf, fnc. R <br /> Name d'� i�Oh `b�k` 255 Glendale Avenue,Suite 21 <br /> Andress ✓ Pa e# of <br /> +'h 02!55 o Sparks,Nevada 89431-5778 <br /> City,State,Zip 4& <br /> Phone (775)355-1044 <br /> Phone Number Fax �7— v Fax (775)355-0406 CI Analyses Required <br /> Client Name `� i P.O.# dab it <br /> �']t 7 +zc <br /> Address PWS k l7WR# t <br /> City,State,Zip r Phone# Fax Ik =, ? <br /> Time Data MR** Office Use Sampledppqq�� <br /> �M Sampled See Key Only C� L L �p0rt G'�„!r7` TotWand ofarbillem <br /> `1 <br /> B&M Lab 10 Number SamWescription *Se b*W REMARKS <br /> � y <br /> ADDITIONAL INSTRUCTIONS: <br /> Prin Name Company Dace Time <br /> Refirtqurshed <br /> Received by _ - - <br /> dt <br /> Relinquishedby <br /> Received by / <br /> I / t - f O 1 I I <br /> Relfnquished bi <br /> I <br /> Received by <br /> `Key: AQ-Aqueous SO-Soil WA-Waste OT-Other *'; L-Liter V-Voa S-Sail Jar O-Oft T-Tedlar G-Grass 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 /> j of the above samples is aoclicable onlv to those samnlps rprpivpd hu the lahnratnry with Ihiz rnr <br />