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i <br /> 13ii4ingation:� Alpha yt;cal Inc. Samples Collected From Which 5ffalre? <br /> Name `< �, -'` ' AZ_ CA� NV_ _ WA <br /> f't' �, 255 Glendale Avenue,Suite 21 1p OR_ OTHER Page 0 of <br /> Address " G` �; v i. Sparks,Nevada 89431-5778 <br /> City.State,Zip �* ✓ - Phone (775)355-1044 <br /> Phone Number5k_&;,74k 6"-54-f Fax .� (i�.(i�/J f Fax (775)355-0406 Analyses Required / ---I <br /> Client Name f� P.O.# Job py a <br /> r 1 ; °CG(/ Required DC Leve!? <br /> Address EMail Address !! 111 IV <br /> City,State,Zip //��' Phone# Fax b `�� }' <br /> - GGC.z <br /> Matrix' Office L'sa Sampled by , RepvriAllenGvn EDD�IEDF�YESNO_ <br /> Time Date J�- Total and type of �,�/'�See Ke Y ' G1ob1A'w <br /> Sampled Sampled BelowY Onl !ab ID Number Sample Descri bon TAT Fiw1d containers �,� <br /> P P ae.ed "See below REMARKS <br /> 79> <br /> y <br /> til% '7�Ir V t v`,G� f <br /> i <br /> i <br /> i <br /> ADDITIONAL INSTRUCTIONS: <br /> or 0 <br /> Si re Print Name Company P Y Date Time <br /> Relinquished ,r r ;1 r ,L r - <br /> Received <br /> ReLnqui d by <br /> _ r _ <br /> Rebnquished by <br /> Received by <br /> "Key: AQ-Aqueous SO-Soil WA-Waste OT-Other "': L-Liter V-Uoa S-Sail 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 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 />