Laserfiche WebLink
BillingIlrmal wn. Samples C011 ted From Which State <br /> 5 L/v✓ Alphalytical, Inc. AZ� CA VV WA <br /> Name 255 GIs Avenue Suite 21 1p OR OTHER e* + <br /> Address 7 Spark§ Nevada 89431-5778 o/ <br /> City State,Zip K-> Phone (775)355-1044 <br /> Phone Number .OVIII& Fax Fax (775)355-0406 Analyses Required , <br /> Client Name [ PO k Jo <br /> Address J �i Required OC Lewr <br /> EMail Address � fl 1f1 IV <br /> City State Zip Phone# Fax# <br /> EDD/EOF7 YES_ 'o <br /> _ <br /> Time Date Matrix Office Use Sampled bye// ReponAllento <br /> Only L L HdpSampled Sampled See!(ey y '"' y G/c6a!!D�Below Lab ID Number Sample Description TAT ,�'aREMARKS <br /> or ��-Q� ✓Ism � - t <br /> Dr 47- Se5 <br /> v (2) 03 1�7 Fe fii� <br /> ADDITIONAL INSTRUCTIONS. <br /> L <br /> r Print Name Company Date Time <br /> Received by <br /> Relinquished by <br /> Received by <br /> Reiinquished by <br /> Received by <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 64 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 pard for the report <br />