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01 Samples Collected From Which State? <br /> Billing firRaU n:� Alpha Ana tical, AZT CA NV_ WA T <br /> Name �" - 255 Glendale Avenue,Suite 21 lD OA— OTHER Page of <br /> - ���_ K ( Sparks,Nevada 89431-5778 • <br /> Address Phone (775)355-1044 09526 <br /> City,State,Zip t. 4& Fax (775)355-0408 Analyses Required <br /> Phone Number• ";7 � Fax ��G�4!"f <br /> Client Name P.O.x Job# 4 `t, Required QC Level? <br /> �/r'1 Ifs/ 2 ac7 7 Milli <br /> Address Entail Address ! !! !!! !V <br /> Phone# Fax# {� <br /> City,State,Zip FTIEDF-7YES_L—NO <br /> Matrix, O"Ice use Sampled by ReportAtlention Total and type of " <br /> Time Date Only � v' containers <br /> Sampled Sampled See KeyFB1d � REMARKS <br /> BelowLab ID Number Sample Description TAT �tered "See below <br /> 51'5 X lvr <br /> II <br /> I <br /> ADDITIONAL.INSTRUCTIONS: <br /> re Print Name y Company Date Time <br /> Relinquished L V Gx'r v'� 7W9 <br /> Received w 6- <br /> Relinqulkd by <br /> Relinquished by f <br /> Received by <br /> "Key: AO-Aqueous SO-Soil WA-Waste OT-Other ": t--liter V-Voa S-Soil Jar O-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 />