Laserfiche WebLink
Acculabs Inc. Lab Number <br />) ] 3902E University Dr. Phoenix AZ 85034 602.437-0979 Fax 437-0826 ~,3 ~ Z/ <br />[ ] 710 E. Evans Blvd. Tucson AZ 85713 520-884-5811 Fax 884-5812 Report <br />I ] 202dW. Lone Cactus Dr. Phoenix AZ 85027 602-780-0800 Fax 780-7695 Due Date: (Z-~1,3 -~/ <br />I ] 4663 Table Mountain Dr. Golden CO 80403 303-277-9514 Fax 277-9512 <br />I ] 992 Spice Islands Dr. Sparks NV 89431 702-355-0202 Fax 355-0817 <br />] J 75 Suttle St. Durango CO 81301 970-247-0220 Fax 247-4227 <br />Client O/~~j/~ ,uC _(tiG~ _ O O <br />Atldress z~0 System Name <br />/ <br />City, State 8 Zip d C_O U~3U~ PWS No. Report to State/EPA Y N <br />Contact POE No DWR No. <br />Phone Project Name Collection Point may////j-pq~s ~~ <br />Fax Project Number Collector's Name ~ype~~ <br />P.O Number <br />SAMP,~,. ~CQ~ S <br />DW =drinking water TB =travel blank <br /> <br />WW =waste water SD =solid <br />MW =monitoring well SO =soil <br />HW =hazardous waste SL =sludge Fax Results Y <br /> <br />Compliance <br /> <br />Monitoring <br />Y N N <br /> <br />S <br /> <br />m <br />p Page <br /> <br /> <br />0 <br />n <br />t .' <br />~ of Location (City) .U <br />Analyses <br />Requested <br />"' TURNQROUNDSRIME~+REQU <br />Standard ESTEp , ,~ <br />Lab Director <br />T ~ <br />~~' e !: <br />RUSH Approval ~ y <br /> <br />Special <br />ACC.~~ENT>~S~SAMF~E(ID7LOCATIO-,~1 <br /> <br />a e TAi-rfe z P .,, <br />~' e' s <br />. <br /> <br />.. <br /> <br />spl. No. <br />/J G~ ~~d p° f ba SPQW ~ <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />InstructionslCommentslSpecial Requirements: <br /> <br />SAMPLE RECEIPT Date' ~Yime' Sample ,, elinguishe B Sa p es~--,gcet e <br />Received Cold Y N ~•)p~j OQ <br />Custody Seals Y N <br />Seals Intact Y N <br />No. of Containers <br />,. <br />:'Acculab's terms are. ~Net~40 (Payment must 6e Fecelved by}th~e~datensliown o t,,e ~ og <br />ee o ~ Isc, o„~nt s o <br />c9excel\formslchain. xls <br /> <br />