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Billing*�na Alpha Analytical, Inc.Name � 255 Glen venue Suite 21Page# of <br /> Address0, Sparks,t a 89431-5778 <br /> City,Stalif Wfla 4& Phone (775)355-1044 <br /> Phone Number�� ( G._G_'c�I Fax D SSL Fax (775)355-0406 Analyses Required 08376 <br /> Client Name Pp # Job-# <br /> Address PWS# DWR# <br /> City State Zip Phone# Fax# <br /> Time Date Office Use Sampled by r f'/ ( ReportAttentio r Total and type of 24 ft <br /> Sampled Sampled See Key only containers <br /> Below Lab ID Number Sample Description ••See below REMARKS <br /> 0570r Ar <br /> )� nY 03 <br /> ADDITIONAL INSTRUCTIONS. <br /> ~+ atu Print Name J Company Hate Time <br /> Refrrtqurshe 04 j t l--> <br /> �1 V <br /> Receive <br /> Relinquished by <br /> Received byk664(7 Ali?hCL lv 2 y Q <br /> Relinquished by <br /> Received by <br /> `Key AQ-Aqueous SO-Soil WA-Waste OT-Other L-Liter V-Voa S Sod Jar O-Orbo T Tedlar f3 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 />