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outing tniormatton, Alpha Analytical, Inc <br /> Name !6'_'s G^ rF 4 rk-����--t 255 Gleniftenue,Suite 21 <br /> Address,3,33 e�rY+ 4_. . Q t_r ��- Ssyi7a�S~tl Sparks,N 89431-5778 Page# --I--Of <br /> City State Zip <_ C IJA•. Q,! Z Phone (775)355 1044 <br /> Phone Number,5',3 D L 7 C--42 CJ Fax I'M L` 74,-e3yr Fax (775)355-0406 Analyses Required 0 8 1 2 7 <br /> Client Name PO # Job# <br /> u 6 A- .20C �dC6S•'C r t1G n <br /> Address PWS# DWR it <br /> City State Zip �y Phone# Fax# <br /> Time Date MaInx Office use 5a by Repontcn ?otalandtypeof i <br /> Sampled Sampled See Key Only �. !� contaislers 1� <br /> Below Lab ID Number Sample Description "See below � REMARKS <br /> 5 + yr r,.-�,� fi I I -r.q T <br /> a41c U -K c- ! 4 T,g-7� <br /> elt �p <br /> .ZYkr ! � T �!t L, <br /> Y <br /> i <br /> I <br /> II <br /> i <br /> ADDITIONAL INSTRUCTIONS <br /> Signa! re Print Name <br /> Company Date Time <br /> Relinquish h 1 <br /> 9 <br /> ��0 /A-4 lr[ e:57-V4./cam �, ,��jf c S� /.2 Z � <br /> Received by 3CL 3/�S / zSf <br /> quashed y <br /> M=V-" <br /> by ' <br /> Q-- <br /> Relinquished by <br /> Received by <br /> 'Key AQ-Aqueous SO Soil WA Waste OT-Other L-Liter V Voa 5-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 samptes 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 col; The liability of the laboratory is limited to the amount paid for the report <br />