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F9733 Hey-C <br /> ALab Number <br /> Acculabs Inc. 2 '�rAW4 �3S <br /> 6 Olive Drive Davis CA 95615 530-757-0920 Fax 753-6091 <br /> ]75 Suttle St Durango CO 81301 970-247-4220 Fax 247-4227 Report <br /> [ ]4663 Table Mountain Dr Golden CO 80403 303-277-9514 Fax 277-9512 Due Date <br /> [ j 992 Spice Islands Dr Sparks NV 89431 775-355-0202 Fax 355-0817 <br /> Client f Fax Results Y N Page of <br /> Address 4(0S rbr44tC�ary PUBLIC WATER SUPPLY INFORMATION <br /> ' City Slate&Zip System Name <br /> Contact lC{� PWS No Report to State/EPA Y N <br /> 1 <br /> Pho a Collector's Name POE No DWR No <br /> Fa CAW Project Nam,—nqq Q , � Collection Point <br /> ' P 0 Number Project Number-1-1l( V— <br /> � LWppq�^'City County <br /> SAMPLE TYPE CODES a C Analyses <br /> ' DW=drinking water TB=travel blank Compliance Requeste <br /> M in <br /> =waste water SD solid Monitoring P a v <br /> :MW <br /> W monitoring well SO=soil Y N e I <br /> ' =hazardous waste SL=sludge I n <br /> TURNAROUND TIME REQUESTED T e <br /> Standard Lab Manager y r <br /> ' q Approval P $ <br /> Special <br /> CLI NTS SAMPLE IDILOCATION Date Spl No <br /> M OJ P 9w--!5A- 2 U] <br /> x_-4Z8 (Z11X �t <br /> [oto PCG s <br /> G� <br /> d <br /> K% >6 O$ <br /> A1 I nits <br /> w_ � � to <br /> ' Instructions/Comments/Special Requirements <br /> SAMPLE RECEIPT Date Time amples Relinquished By Samples Received By <br /> Received Cold Y N <br /> ' Custody Seals Y N f� tsar <br /> Seals Intact Y N <br /> ' No of Containers <br /> Acculabs,Ines Standard Terms and Condttians apply unless written agreements specify otherwise Payment terrns are Met 30 <br /> 1 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 <br /> received unless other arrangements are made in writing This limitation shall apply regardless of the cause of action or legal theory pled or asserted <br /> 301 2E <br />