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<br />rAcculabs Inc. Lab Number <br /> <br />[ ] 1725 W. 17th. St. Tempe AZ 85281 <br />480-967-1310 Fax 967-1019 7 <br />~ 9o Q - ~ $.3 - D1 <br />[ J 4455 S. Park Ave. Tucson AZ 85714 520-807-3801 Fax 807-3803 Repon <br />[ j 2029 N. 4th St. Flagstaff AZ 86004 520-774-7643 Fax 774-7648 Due Dale ~ ~ ~ r ( <br />[ ] 1046 Olive Dnve Davis CA 95616 530-757-0920 Faz 7538091 <br />[ ] 75 Suttle St Durango CO 81301 970-247-4220 Fax 247-4227 <br />[ ] 4663 Table Mountain Dr. Golden CO 80403 303.277-9514 Fax 277-9512 <br />[ ] 992 Spic <br />e Islands Dr. Sparks NV 89431 775-355-0202 Fax 355 0817 <br />L <br />Client ~ O,T .r G; L\O-,` -f1 Fax Results Y N Page of <br />Address 4 ZL( G2 j Z-O PUBLIC WATER SUPPLY INFORMATION <br />Ci State 8 Zip CS <rwS <br />ty, <br />p I ~Si <br />System Name <br />Contact PWS No. Report to State/EPA Y N <br />Phone Collector's Name POE No DWR No. <br />P.O. Number Project Number Lo lion (City) <br />SAMPLE TYPE CODES Analyses <br />DW = tlrinking water TB =travel blank Compliance 3 C Requested ~ !J <br />WW =waste water SD =solid Monitoring a o - <br />MW =monitoring well SO =soil P t ~ S o yl ~ <br />HW =hazardous waste SL =sludge Y N ~ I a '''' ~ ~ ~ t <br />TURNAROUND TIME REQUESTED e I ~ ~ y <br /> <br />Standard <br />Lab Manager <br />n ~ <br />'~ 4 ~ ~ <br /> <br />RUSH <br />Approval <br />T <br />e r <br />~ 4 CS r <br /> y r c' y <br /> <br />Special P s d W () - <br />~ <br /> a ~ ~ <br />CLIENT'S~SAMPLE IDILOCATION Date Time Sal. No. <br />l <br />SAMPLE RECEIPT Date Time Samples Relinquished By Samples Received By <br />Received Cold Y N a~ )~•~~ <br />Custody Seals Y N <br />Seals Intact Y N <br />No. of Containers <br />Acculabs' terms are: Net 40 (Payment must be received by the date shown on the Invoice or any discount is void) <br />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 <br />unless other arrangements are made in writing. This limitation shall apply regardless of the cause of action or legal theory pled or assened <br />A301E <br />