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BillingInfo tion; Alpha Ail tlCal, Inc. Samples Collected From which State? <br /> �i�t ..s C.� .7.�....kaw�f p Y Az CA_ NV WA— <br /> Name 255 Glendale Avenue,Suite 21 ID OR OTHER Page of <br /> Address .333 v C..K•0-. p+G �'• dM r/6 5rSV Sparks,Nevada 89431-5778 <br /> City,State,rp G +400-0•~ C. 4rw « Phone (775)355-1044 Anal 5eS 1 ie Uired <br /> Phone NumberdMID t 49-4"`1 Fax IrI)0«�-Looa Fax (775)355-0406 y 4 09665 <br /> I Z <br /> Client Name P.O.a Job a Required RC Level? <br /> LC 5 A Zs o7-�aL.�O / S! <br /> Address ENfail Address 11 /it 11/ <br /> IQ <br /> City,State,Zip Phone 0 Fax F it EDD/EDF7 YES [ xo— <br /> Lo•�� C <br /> Matrix' 0 ce Use Sa by-- Re ort Attention Total and type of �a Globaill)e D 0 7 eoos <br /> Time Date Only T'. 1'"e 1 S ti .'L 0.o ro �.i tc. <br /> rs <br /> Sampled Sampled See Key Reid `See below <br /> Below Lab ID Number Sample Description <br /> AT dared See below 1. REMARKS <br /> oes y r u s R t S'19 Z.le X <br /> ofYo IIiL b 4 4 s A 1."f' S <br /> ADDITIONAL INSTRUCTIONS: <br /> Signature Print Name Company Date Time <br /> Relinquished by ��.� �� t 0�� s j <br /> Received by .LZS 5 C'�C I6 <br /> Relinquished b7y j <br /> Received by <br /> Relinquished by <br /> Received by <br /> 'Key: AQ-Aqueous SO-Soil WA-Waste OT-Other L-Liter V Voa 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 />