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Acculptbs Inc. , Lab Number <br /> 046 O1rGe 1Jnve Daws A 95616 530-757-0920 Fax 753-80 �� <br /> 75 tie St Duran CO 81301 '' 970-247-422x 247-•4227" " ReporT"`� '----- ---•- <br /> }4� W M taln Dr.Golden CO 80403 303�95'l4 Fax 277-9512 Due Date f <br /> ( } 2 Spice stand§Dr Sparks NV 8943 X776-355 0202 Fax 355-0817 <br /> f <br /> Client 10 Fax Results Y NPage of <br /> ddress /' PUBLIC WATER SUPPLY INFORMATION , , u <br /> City,State&zip , � System Name <br /> :Contact�--� �b'- --,( a�1� PWS No Report to State/ <br /> EPA Y N <br /> Pho e _ Collectors flame rr� POE No DWR No <br /> Fax - ?�? J 1 <br /> U Protect Name fr 7 Co]lection Point <br /> P O Number r - Project Number- a Crty County <br /> Anaiyses <br /> � a . <br /> DW=dnnking water TS= ravel blank- ;`:- Compliance Requests <br /> /-J <br /> waste water SO=solid " Monitor ing <br /> MW- onitonng well SO=soil =�� Y <br /> 1.461haiardous waste` SC=sludge' AA�-- - _- <br /> �" ilKWAROUIO TIME Rl STEC1 <br /> Standard Lab Manager <br /> 44_ Approval <br /> Specials <br /> SAMPLE idiLdc-Andi&t Dat+ T t,; *$ <br /> Sp1 No <br /> IMw-- (0 - (-8-o Acs` <br /> ~ ,h <br /> 7.r <br /> W' - E,.19 X <br /> MWA <br /> s w �- <br /> I r 1 = <br /> r <br /> - ,• <br /> Instructions/Comments/Special Requirements <br /> SA f?1.6 E 1 ate" Time , V S mples Relinquished By Samples Receive <br /> Received Cold Yr M N { <br /> th <br /> ustody Seals Y N ( � / <br /> Seal&Intact Y N <br /> No of Containers <br /> ill s w i e inents sppcifysothei�v,se Payment terms are Net 30 <br /> To the maximum extent permitted by taw;the Client agrees to limit the liability of Accutabs,Inc for the Clrent's damages to the total compensation <br /> recelved unless other arrangements are made writing This limitation shall apply regardless of,the cause of action or legal theory pled or asserted <br /> 301 2E _ <br />