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IAcculabs Inc. Lab Number <br /> [ ] 1725 W 17th St Tempe AZ 85281 602-967-1310 Fax 967-1019 1 � <br /> [ ]4455 S Park Ave Tucson AZ 85714 520-807-3801 Fax 807-3803 Report <br /> ]2020 W Lone Cactus Dr Phoenix AZ 85027 602-780-4800 Fax 780-7695 Due Date <br /> ]2029 N 4th St Flagstaff AZ 86004 520-774-7843 Fax 774-7648 <br /> [ ] 1046 Olive Drive Davis CA 95616 530-757-0920 Fax 753-6091 <br /> [ ]75 Suttle St Durango GO 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 702-355-0202 Fax 355-0817 <br />' Client e� PUBLIC WATER SUPPLY INFORMATI6,I <br /> Address T n System Report to State Y N <br /> City State&Zip 4L412r,rC z— Sy 3 PWS No Report to EPA Y N <br /> Contact POE No DWR No <br />' Phone tD Project Name Collection Pant <br /> Fax 770 Project Number $ Jr0 C9 Collector's Name <br /> P O Number Fax Results N Page of Location(City) <br /> fr�T�YPE. ,0P ES- ' ` x -J,' Analyses <br /> DW=drinking water TB=travel blank Compliance Requested <br /> WW=waste water SD=solid Monitoring <br /> IMW=monitoring well SO=soil N <br /> HW=hazardous waste SL=sludge <br /> t WAROUND TIMEAEQUESTED <br /> Standard Lab Manager �C! <br /> RUSH Approval j <br /> eGal <br /> Nti0iMPLE` ILOCAT(ON Date Time Spt No z <br /> cvr io o3 <br /> -.-?- N- <br /> Instructions/Comments/Special Requirements <br /> SAMPLE RECEIPT Date Time Samples Reli qu bred By Samples l3eceived B <br /> Received Cold Y N <br /> Custody Seals Y N <br />:0Is Intact Y N <br /> 0 of Containers <br /> Accu labs'terms are Net 40 (Payment must be received by the date shown on the Invoice or any discount is void) <br />