HYDRO26714

• Permit No: C1981035
• IBM Index Class Name: Hydrology
• Doc Date: 11/3/2000
• Doc Name: acculabs inc
• Permit Index Doc Type: OTHER GROUND WATER
• Media Type: D
• Archive: No

FR 734 Rav (:
Acculabs Inc.
( [ 1046 Olive Drive Davis CA 95616 530-757-0920 Fax [phone] Lab Number
7 -~0 - 6 -Q
[ J 75 Sutlle St. Durango CO 81301 970-247-4220 Fax [phone]
[ ~ 4663 Table Mountain Dr. Golden CO 80403 303-277-9514 Fax [phone] Repon
Due Date
[ J 992 Spice Islands Dr. Sparks NV 89431 775-355-0202 Fax [phone]
Client ~T~ [~ / ~ / Faz Results Y N Page of
Address ~}!{Z ~ GR !L O PUBLIC WATER SUPPLY INFORMATION
City, State 8 Zip ~~f- ~~ Z[~ System Name
Contact T 8 ` PWS No. Report to StatelEPA Y N
Phone Collector's Nam N N ~~~ Gt-+e POE No. DWR No.
Fax Projec: Name Collection Point
P.O. Number Project Number City County
SAMPLE TYPE CODES S ~ Analyses

DW =drinking water TB =travel blank
WW =waste water SD =solid

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

~ ~ N a
m
P
1
e o
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Requeste
TURNAROUND TIME REQUESTED T e
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Standartl Lab Manager y r
RUSH Approval e s
Special
CLIENT'S SAMPLE ID/LOCATION Date Time . Spl. No.
[( f' S-Z?a~ l ~~7 W G

Instructions/Comments/Special Requirements:

SAMPLE RECEIPT Date Time Samples Relinquished By Samples Received By
Received Cold Y N ~WbU
Custody Seals Y N
Seals Intact Y N
No, of Containers
Acculabs, Int.'s Standard Tenns and Conditions apply unless written agreements specify otherwise. Payment terms are Net 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 arrangements are made in writing. This limitalron shall apply regardless of the cause of action or legal theory pled or asserted.
301.2E