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Samples Coll cted From Which State? <br /> Name � 1^4`VL,01S .. 1'✓l.� Alpha Analytical, Inc. AZ� CA X HV— WA <br /> Address ` 1 255 le Avenue,Suite 21 1p OR_ OTHER <br /> Spa vada 89431 5778 Qge#—Lof—L <br /> City,State ✓N�i Phone (775)355-1044 <br /> Phone Number k4 tax ' Fax (775)355-0406 Analyses Required 0 <br /> Client Nance <br /> PO # Jab# <br /> 543 / <br /> Address EMail Address Required Oc LeYel? <br /> C+ty State Zip - 1 11 !11 IV <br /> Phone>< Fax# <br /> i me Date Matrix' [office Use camp ed l7 � fu�� Repon Atten t <br /> J ,EDD/EDF? Es-x NO <br /> Sampled Sampled See Key o71y �J,C_,�c Total and type of <br /> Below Lab ID Number Field containers Gfoba!!D <br /> Sample escnptian TAT £ <br /> _ ere ed <br /> See� <br /> G 7 REMARKS I7 S�C(Z(7S�ZO�oZ-o j �l�/� ld^ <br /> ADDITIONAL INSTRUCMIONS, <br /> S a e Pnnt Name <br /> jAelinquishidby Companyev DateTimeceive <br /> Relinquished by � <br /> 2 5-V `L r <br /> Received by r <br /> Reifnquished by CSL `k�1rJ 0. <br /> Y 00 <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-Plastsc OT-Other <br /> NOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be retumed to client or disposed of at client expense The report for the analysis <br /> f 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 ranno <br />