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oirnng inTormation <br /> Alph nalytical Inc • <br />� Name � I �'"�-�� �n a , r` y ��r{ 255 a Avenue,Suite 21 <br /> Address C�.sa-t;ro., /�_ Page#—_� _—of <br /> J' �; �;� Sparks, evada 89431 5778 <br /> City State Zip Phone (775)355-1044 <br /> Phone Numbers 2 D L. 7 4-14 Cc Fax C S7 Fax (775)355 0446 Analyses Required (Qj 12 <br /> Client Name PO # Job N 4 <br /> Address PWS# <br /> I <br /> City State Zip Phone# Fax>r <br /> Time Date { OHpniuse Sam by t ReporLA[lention J Foialandiypeof �' <br /> Sampled Sampled See Key y "''r r I �"� contaEners <br /> Below. Lab Il]Number Sample Descnption ""See below <br /> REMARKS <br /> •S <br /> r4 7- <br /> J 7 7- <br /> 1 F4 r <br /> r1F} r Ire <br /> I f <br /> { <br /> ADDITIONAL INSTRUCTIONS f <br /> Signa! re Print Name ' Company <br /> Date Time <br /> ReMqulsh b �,//}� <br /> Received by <br /> qulshed y <br /> C <br /> ed by <br /> Helinguished by I <br /> Received by <br /> "Key AO-Aqueous SO-Soil WA Waste OT-Other L Liter V Voa S Sod Jar 0 Orbo 1 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 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 />