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tsming t AI ll �� � ha Analytical, Inc. <br /> � v 5 p Y AZ_ CA� NV_ WA <br /> Name y .. 255 GlandaljjWue,Suite 21 } <br /> Address 7i✓1 t% Sparks, Nsv 431 5778 !� OR OTHER Pag of ` <br /> Cs State Zi f"ci- � u-' Phone (775)M-1044 <br /> ry' p ] Fax (775)355-0406 Analyses Required <br /> Phone Number a2 %'�7 Gi�E7 rax 7 r lr�iG[T Y Q <br /> Client Name �`�` P.O.# .}op# <br /> Ll 5 le :-5- <br /> Required OC Level? <br /> Address EMail Address <br /> I u U/ ►V <br /> City,State.Zipl r Phone# Fax# <br /> �-11 f EnniEDF?res_ NO <br /> Time Date Mat ix' Office Use Sampled by f�1/�7/f(�(� Report Attenlio Total and type o1 <br /> See Key Only [ canta!ners f crobar ro w <br /> Sampled Sampled 13elaw <br /> Lab ID Number Sample Description TAT Feld A low 1` REM RKS <br /> R p Filtered ' Se.be <br /> ADDITIONAL INSTRUCTIONS: <br /> a e Print Name Company Date Time <br /> Relin e / <br /> Received by <br /> Relinquish d��'" � � <br /> Received by <br /> IL <br /> Relfnquis'ed <br /> Received by <br /> 'Key: AQ-Aqueous SO-Soil VIA-Waste OT-Other ": t--Uter V-Voa S•Soil Jar O-Orbo T-Tedlar B-Brass P-Plasft OT-Other <br /> NOTE: Samples are discarded 60 days atter 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 />