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Bifling�l for ' n: Alpha.A !cal, Inc. <br /> !Name ✓ m k e 255 Glendal�llE;nue,Suite 21 page# of <br /> av <br /> Address � ✓ �!� #�y� Sparks,Nevada 89431-5778 <br /> City,State,Zip 4 sr k- o v Phone (775)355-1044 <br /> Phone Number '� Fax Fax (775)355-0406 Analyses Required <br /> IF}' it. 01!L <br /> Client Name P.O.# Job# <br /> Address PWS# DWR# <br /> City,State,Zip 4k Phone# Fax# <br /> D / <br /> Time Date Office Use Sample" ReportAtte n p� r Total and type of <br /> Sampled Sampled See Key only (� containers ,q <br /> Below Lab ID Number Sample Description "See belREMAR.K�Sr_, <br /> WX410i ot k FIr <br /> r. <br /> r T_. <br /> r <br /> ADDITIONAL INSTRUCTIONS: <br /> t e Print Name Company /Date Time <br /> 'Relinquis'hed y W <br /> Received b 19- <br /> Relinquished by C <br /> Received by I <br /> j Relinquished by <br /> ecelved by <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 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 anal.0is <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 />