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Billing Information: EDDIEDF RegUiratlT yes N <br />Address: C-4"IDO <br />City, State, Zip: CC LevelRSQdrod9 I IN <br />Samples Collected from which Ste le9 (circle ons) AZ A NV WA 10 OR Other It Iv <br />Nha,B,rpC <br />r9. °!, Alpha Analytical, Inc. <br />�'� 255 Glendale Avenue <br />, , Suite 21 <br />Sparks, NV 89431 <br />t4�onnnenlb, (775) 355-1044 <br />(775) 355-0406 Fax <br />Pa e # 1 of 1 <br />a, <br />Chem: Broadbent P.O.: 11-10-106 Job: PiloVF"gd <br />Sampled by: Sam BeRe Attention: we rp a, na u , <br />Time <br />Sampled <br />Dale <br />Sampled Matrix • Lab ID or lab Use L <br />TAT <br />( Working <br />Sam is Descri tion Containers" D <br />N � <br />o w <br />ao <br />0 X <br />LLJ <br />0 M <br />Reserved by: % -% f <br />Remarks <br />IpfQ <br />08f16f11 'C <br />P-1 S <br />X X <br />0 Q <br />08118111 <br />P-2 S <br />X X <br />ADDITIONAL INSTRUCTIONS: <br />Pri <br />Name Can Data Time <br />Relin ufshed b : C' V, <br />Reserved by: % -% f <br />Relinquished by: <br />Received by: r` <br />Relinquished by: <br />Received by: <br />*Key, AO -Aqueous WA - Waste OT - Other °°: L - Liter V - VOA S -Soil Jar O - Orbo T - Tedlar B - Brass P - Plastic OT - Other <br />NOTE: Samples aro discarded 60 days after sample receipt unless otter arrangements ars made. Hazardous samples wig be rea ned to diets or disposed of at client expense. The eport for the analysis of the above samples is <br />applicable only to those samples received by the laboratory with this COC. The HabBty of the laboratory Is limited to the amount paid for the report <br />