HYDRO25522

• Permit No: C1981035
• IBM Index Class Name: Hydrology
• Doc Date: 4/2/2001
• Doc Name: mine & 581 cr 123
• Permit Index Doc Type: OTHER GROUND WATER
• Media Type: D
• Archive: No

FR7.'~'3 Rav C'
Acculabs Inc.
[ (1046 Olive Drive Davis CA 95616 530-757-0920 Fax [phone] Lab Number
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( 1 75 Suttee St. Durango CO 81301 970-247220 Fax [phone]
[ [ 4663 Table Mountain Dr. Golden CO 80403 303-277-9514 Faz 277-9512 Repon
Due Date
j 1992 Spice Islands Dr. Sparks NV 89431 775-355-0202 Fax [phone]
Client - _ Fax Results Y N Page o!

Address - - '~a s•. - ,,5•+~~..+..~,.
PUBL•IC~WATER SUPPLY INFORMATAA~I N
City. State 8 Zip 3 System Name
Contact - PWS No. Report to StalelEPA Y N
Phone ~~~ G d L ~ Collector's Name S~ ti . - ~ _ POE No DWR No.
Faz Project Name Collection Pomt
P.C. Number Project Number Cily County
~`~'°"'',~` SAMPLE TYPE CODES''~~ ~,; S ;
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r* C Analyses
DW =drinking water TB =travel blank
WW =waste water SD =solid

MW =monitoring well SO =soil
HW =hazardous waste SL =sludge Compliance
Monitoring

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RUSH Approval
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Spl. No.
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InstructionslCommentslS pecial Requirements:

SAMPLE RECEIPT Date Time Sa les Relinquished By Samples Received By

Received Cold Y N of
D~U
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Custody Seals Y N
Seals Intact Y N
No. of Containers
Acculabs, tnc.'s Standard Terms and Conditions apply unless written agreements specify otherwise. Payment terms are Ne[ 30.
To the maximum extent permitted by law,~the Client agrees to limit the liability of Acculabs, Inc. for the Client's damages to the total compensation
received unless other anangements are made in writing. This limitation shall apply regardless of the cause of action or legal theory pled or asserted.
301.2E