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,i, u nPlug 111d{1411 Alpha Analytical, Inc <br /> Name �vS L fi/[/ 255 Glendale Av uite 21 <br /> Address �►wr.�d� t�Nr AA <br /> Sparks,Nevada 15778 page ff��of <br /> y city,State,Zip 40 h 4 Phone (775)355-1044 _ <br /> D Fax (775)355 0406 Analyses Required <br /> Phone Number �rG Grli Fax "6%G fid�}�j <br /> Q Chent Name <br /> � 5 PO Job ti <br /> Address PWS if owFi a <br /> city State Zip / , Phone t+ Fax a �J <br /> (r o <br /> Time Date Se QbOnly 5ampledbY ReppllAttenho ` t7 Tdalandtypeof �` cc <br /> Sampled Sampled y Only � <br /> D p V Below Lab 10 Number Sam leDescn e5�nt,�y <br /> P X00 REMARKS <br /> _ <br /> 21 H IZ <br /> a <br /> 7-1 <br /> a <br /> n <br /> 4 <br /> �w WPlow awdom ~ <br /> S <br /> a <br /> w <br /> 9 m <br /> J rn <br /> 4 ca <br /> n <br /> 9 � <br /> 1 <br /> E <br /> E! <br /> LL <br /> ADDITIONAL INSTRUCTIONS: <br /> i <br /> N <br /> 5lg ure,� rd Pnnl Name Company Dale lime <br /> Relinquished <br /> � Recearedby ��,�• '�1%�(�1M,0 �uGIGIN�b 6eeSIT <br /> ` /`v / N <br /> l 1 � <br /> Miriquished by <br /> 7 v <br /> I <br /> REord by ` �— 4 <br /> I � Rdn4ulshedby � <br /> h Received by <br /> f 'Key Aa Aqueous 50-Sol! WA Wasle OT Other L Liter V Voa S Soil Jar 0 Orbo T Tedlar 8 Br855 P Plastic QT Olhet <br /> MOTE Samples are discarded 60 days after results are reported unless other arrangements are made Hazardous samples will be returned to chertl or disposed o1 al client expense The report for the analysis <br /> of the above samples rs applicable only to those samples received by the laboratory wllh this coc The liability of Iha lahnralnnr w fimitn,41.,ik. .M , <br />