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i <br />AccUlabs Inc. - -ab Number <br />[ ] 1725 W. 17th. St. Tempe AZ 85281 480-967-1310 Fax 967-1019 <br />[ ] 4455 S. Park Ave. Tucson AZ 85714 520-607-3801 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 />[ ] 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 Spice Islands Dr. Sparks NV 89431 775-355-0202 Fax 355-0817 <br />Client Q CC + Fax Results Y N <br />Page of <br />Address OW <br />City, State & Zip System Name <br />Contact RG ii 0 S;J7a <br />f <br />ke*L PWS No. <br />Report to State/EPA Y N <br />Phone G 6 - ? �Z- '7-,� 5 <br />Collectors Name 1-vD✓ 1 �7'- vv e-- I POE No. <br />DWR No. <br />Fax <br />Sr^.Yr 4[t H� :LH �i <br />ect Name Ma ,. tc, j�� 'c hr LcxTvo' C)� pllection Point T-7 J I S - 1'w %1" ,%-f <br />P.C. Number (r'' <br />Z Z3 $T <br />+PP::ectNumber 1 I -2--> Location (City) <br />rs , <br />J: <br />, .vp <br />" <br />wy <br />, .p <br />e <br />Cr; <br />n <br />t - <br />a <br />m; <br />T <br />a, <br />Analyses <br />Requested b <br />CO <br />h <br />N W <br />b I P <br />�� \ ��' <br />Spl. No. <br />DW = drinking water TS = travel blank <br />WW = waste water SD = solid <br />MW = monitoring well SO = soil`m <br />HW hazardous waste SL = sludce <br />Compliance <br />Monitoring <br />Y N <br />w ::7 URNAROUNDTlME;REQUESTED <br />Slandartl ✓ <br />Lab Manager <br />Approval <br />RUSH <br />Special <br />CLIENTS".SAMPLE IDILOCATION< c <br />e Date <br />Time <br />7�-S- f �-' <br />S-� 0 <br />K <br />Y <br />—(�— <br />�r <br />tj <br />(4 ZD <br />K <br />/ <br />t _ N — [ SS <br />-i ca <br />f 4L50 <br />ISO <br />r-�= ISr <br />-7 <br />XXL <br />IY <br />iL�Itol <br />C) <br />c- <br />9-11-00 <br />If44Z <br />I SD <br />i <br />X <br />X <br />x <br />X <br />1444 <br />GO <br />I <br />Y <br />x <br />t- <br />Instructions/Comments/Special Requirements: + Nlo 1', 11-11D D e <br />...�.- _..-cuia:wg .�r�ay <br />'SAMPLERECEIPT' <br />Date <br />r Time <br />.. _., <br />Samples Relinquished B <br />.,i ;�s^�:•, <br />-SamplesRecelved W <br />Received Cold Y N <br />;�sl-Lb <br />O <br />Custody Seals Y N <br />Seals Intact Y N <br />No. of Containers <br />-a'Acculabs' termsar'e.`Ydet#�t7(f'ayment must be received by ttie date shown onYhe;lnvotcenrany dtscount�is votd)'" <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 asserted. <br />A301 <br />