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Alpha Analytical, Inc. <br /> Name t"✓L ✓ 255 Glend`�� 9nue,Suite 21 {$ <br /> Address r.yam Sparks,Neth_.19431-5778 Page# of� � 3 4 6 x <br /> City,State,Zip Phone (775)355-1044 .4, <br /> Phone Number Fax y .,r H (�G`7G'� Fax (775)355-4406 Analyses Required <br /> _ — <br /> '- Client Name ,3 rj �� - - -- ---- 'P.O.-# <br /> Address t7 <br /> PWS# G/ 1 <br /> City,Stale,Zip WR# i <br /> Phone#. #- - <br /> 1J <br /> _ � � ... :.-� . ..., .. Fax <br /> Time Bate Matt(* Office use Sampiedby / � Report Attention `1 �• Tlt:fLotal andrypeof <br /> Onl ,yam <br /> Sampled Sampled See Key y / � r containers <br /> Below Lab IDNumber Sample Description5eebelow REMARKS <br /> C71/3 ?, '; ?� c��i �� �-fit '1 , �w .-i1. <br /> ADDITIONAL INSTRUCTIONS: <br /> e Print Name Company Rate Time <br /> Relinqu3by <br /> y <br /> Receive :7 <br /> 272k Relinquished by <br /> Received by # <br /> �� _ !����'��.. t�•) ,. !�,(_'.rte ��j ;�-� ''U{t� �"t�-f E:i <br /> Relinquished by <br /> Received by <br /> 'Key: AQ-Aqueous SO-Soil WA-Waste OT-Other t": 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 /> 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 />