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Acculabs Inc. Lab Neu /tuber u <br />[ ] 1725 W. 17th. St. Tempe AZ 85281 480-967-1310 Fax 967.1019 ` ~ ~ ~ Z ^ ~ ~7 0 (~ 0 <br />[ ] 4455 S. Park Ave. Tucson AZ 85714 520-807-3801 Fax 807.3803 Report <br />[ ] 2029 N. 4th St. Flagstaff AZ 86004 520-774-7643 Fax 774.7648 Due Date: -~' <br />[ ] 1046 Olive Drive Davis CA 95616 530-757-0920 Fax 753-6091 <br />5 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 Spice Islands Dr. Sparks NV 89431 775-355-0202 Fax 355-0817 <br />t <br />Client s <br />Fax Results Y N / <br />Page of <br />Address <br />~PUBLI~~CINATER SUPPLY~INFQRMATION <br />City, State & Zip System Name <br />Contact PWS No. Report to State/EPA Y N <br /> <br />Phon <br />e <br />~ <br />a7~-~- <br />Collector's Nam -Pi <br />POE No. <br />DWR No. <br />( <br />}~/ <br />Fax~( (Q- - Project Name Collection Point <br />P.O. Number Project Number y~-7 Location (City) <br />4~::rs"~` .s, _:=;`-SAMPLE.TI'PE=CODES '~' ,1, ~•¢x -~' .~, '~`- Analyses <br />DW=drinking water TB=travel blank <br />WW=wastewater SD=solid <br />MW =monitoring well SO =soil <br />HW =hazardous waste SL =sludge <br />r~`". ,r ~TURNAROt1ND;TIME'-REQU Compliance <br />Monitonng <br />Y N <br /> <br />ESTED ?'~.-„ '~Sr~ <br />a',.~''t <br />p~ <br /> <br /> <br />~, <br />';"Bti' <br />~ ~~2 ~'= <br />~'o <br />~t~t+ <br />;~: <br /> <br />i ~.. <br />`i ~` Requested <br /> <br />Standard <br />Lab Manager ~ <br />`'. :+ *Pq <br />.c? <br />RUSH APProval ~::T' hseitr` <br /> <br />Special <br />,St P' n <br />`GLIENT4S;$ ~ PLE IDICOCATION 'Date,•s ~ ;Time ` i e~ <br />~ Spl. No. <br />~I~Ds to~5z ~ ~ i ! 3 x a <br />I 3z ~5-2 ~/( 12 3 X o2 <br />'1 I sa I o Z~(- l3 ~ ~ o <br /> ~3'r- ] X o <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Instructions/Comments/Special Requirements: ~ ~ ' VI"D 3 ~~~ <br /> <br />~k't19~"f3~z^~ _ ~o .. m~ -y }.~?.~~-~ <br />§ -~?a~~-~SAMP,-LE RECEIPT ~^~;~ 3~-~r~~tkk,r <br />~Dat ~ . - bx ~' <br />~ ~Tifne„ :~~ +~*.3 P,~Ya;>#+r1 '~ vx.rw s%a-'~~M'"'~? yi. <br />:,:; Sa pies tin ,fsl~ed B ,r,~v t+"~~+" .."'/~`.{`3$'~c~ v "§.. ` <br />r~r,;~ SamFl~es+RecRivesl~ ; ~„;. <br />Received Cold Y N ~ t <br />Custody Seals Y N <br />Seals Intact Y N ' <br />o. of Containers <br />4 -,~ ~.~t .. "~°'} Ti ~e "CZQ L at~"hi. EY2 5L4.. L <br />;~" „f Acculabs3terms are Net ~Q~(Paymertt rnustrbe <br />Jy..:+ C. Y i*- 2Y ~ ^Y CJh ~4 <br />Trecelve~by the;date shown on~theUlnvo3 ~rv <br />~'-311 9~g M £~ z.~{ ifs; 6 4K <br />ce or a~n~!.dis~count is voted) ~~ ~;~ <br />r <br />L <br />To the maximum eMent permitted by law, the Clientagrees 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 asserted. <br />A301E <br />