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Billing Intorr, `yn: Alpha A tical, Inc. • <br /> Name 255 Glendale Avenue,Suite 21 3 <br /> Address `' "'� ` �-J �'. rL.- Sparks,Nevada 89431-5778 Page# of <br /> City,State,Zip c Phone (775)355-1044 <br /> Phone Numbpr C Cx CILI�`> Fax G zW `c- Fax (775)355-04100 Analyses Required 0 _ <br /> Client Name f— <br /> P.O.# Job# >` <br /> Address ( a <br /> PWS# DWR 0 " <br /> City,stato <br /> Phone» Fax p <br /> r C,lc,:i,:L <br /> Time Date maw. 'officeUse Sampled r/LL. fteportAttention��� r, Total and type of � <br /> Sampled Sampled See Key Only <br /> containers f j r u i,o �7c-'tet <br /> / Below LablDNumber Sample Description "'See below "1 REMARKS <br /> Aii`7 tlr7�o Ck ���94• <br /> ct>� z ✓ <br /> I <br /> ADDITIONAL INSTRUCTIONS: <br /> Reb i�hediSignPrint Name Company Date Time <br /> Rels ' �Receiv by I e"f X714 �` /�✓I <br /> Relinquished by <br /> c �ved by / <br /> Relinquished by <br /> r� AV<2�3 /0 " <br /> Received by <br /> "Key: AO-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 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 /> n(tha ahnvp samnlgS is annlirahle only to those samples received by the fahoratory with this rnr Thn liahili+i,„r+h <br />