Laserfiche WebLink
Billing 0matiamAlpha yticaf, Z Samples Collected From Which State? 0 CA <br /> -1 <br /> Name ST.sTw, t�u rr.» �.,t4 Inc.InC. ,,�;'_ NV_ WA <br /> 255 Glendale Avenue,Suite 21 !D OR OTHER Page a _ <br /> AddressDJAO Pff tO,. ,S.,Ts SSo Sparks, Nevada 89431-5778 <br /> City,State,Zip C[w. .r.a o. X, Gar '�SLg _ 46 Phone (775)355-1044 <br /> Phone Number iFr oY Fax tJ�O 6Tr Goo.! Fax (775}355-0405 Analyses Required <br /> Chien!Name r P.O.p Job# y ` <br /> Lc S14 4 3 .3a67—oo�S—a f Required QC Level? <br /> Address EMai!Address k <br /> 6 11 111 IV <br /> City,Stale,Zip Phone ti Fax <br /> ILIA; Ga EDD/FDF?YES y NQ_ <br /> Time Dale Matrix Office Use Sam fe�py Re otAtten!i k <br /> r ° i4 To!al and type of <br /> Sampled Sampled <br /> See Only .1. '� �' �`�� conlairers Global 00 n' <br /> Below Lab ID Number Sample Description TAT F retm "See below REMARKS <br /> Izli? l�:sar �:Rug U-z - it LLsAcaria S^F I7 Y X <br /> t !IL UZ' (•t34LS 14' szn _�+� <br /> rlos u,f4 ss CFS AVA..7-4 T <br /> I <br /> i <br /> I � <br /> j ADDITIONAL INSTRUCTIONS: <br /> Sign r Print Name Company Date Time <br /> Re!inGu . db, - <br /> 5• / 1 <br /> i�ow o� Fv- Is.•t vrT—ic�Tk� L�+J ylL/ate Z,0 <br /> Receded <br /> !��� . 1�'�C.tCLs-�-�� �r l�Yv`C-t �'-�-� G�i„t''G•C� <br /> ReGnquis'ied by <br /> ReceivedbyFS <br /> ReliquMsheliby =�J <br /> Received by <br /> 'Key: AQ-Aqueous SO-Soil WA-Waste OT-Other ": L-Liter V-Voa S-Soil Jar O-Orbo T-Tedlar B-Brass P-Plastic OT-Other <br /> NOTE: Samples are discarded 60 days after resin?s are reported unless other arrangements are made. Hazardous samples wil;be returned to cent or dis osp_d °.at !;p_nt expense. The report fcr thA <br /> a alysis <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 arnount paid for the repot. <br />