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1 <br /> ACCUE3195 Inc. <br /> [ J 1725 W 17th St Tempe AZ 85281 Lab Number �� <br /> [ ]4455 S Park Ave Tucson AZ 85714 602-967-1310 Fax 967-1019 <br /> [ ]2020 W 520-807-3801 Fax 807-3803 Report <br /> Lone Cactus Dr Phoenix AZ 85027 602-780-4800 Fax 780-7695 <br /> I J 2029 N 4th St Flagstaff AZ 86004 Due Hate <br /> [ 1046 Olive Drive Davis CA 95616 520-774-7643 Fax 774-7648 <br /> [ j 75 Suttle St Durango CO 81301 530-757-0920 Fax 753-6091 <br /> [ j 4663 Table Mountain Dr Golden CO 80403 970-247-4220 Fax 247-4227 <br /> I 303-277-8514 Fax 277-9512 <br /> 1992 Spice Islands Dr Sparks NV 89431 <br /> 702-355-0202 Fax 355-0817 <br /> Client PUBLIC WATER SUPPLY INFORMATION` <br /> Address 7 a r ,JVto <br /> J System Report to State Y N <br /> City State&Zip �' �, ��� <br /> 'L PWS No Report to EPA Y N <br /> Contact LST r� ��/�- <br /> POE No DWR No <br /> Phone 3-7 v Project Name �1/ �D[,/t fGG+= `q�7 <br /> `, /r ollection Point <br /> Fax Project Number 7 <br /> Collectors Name <br /> ' P O Number Fax Results9 <br /> SAMPLE TYPE CODES N Page &of Location ) <br /> DW=drinking water TS=travel blank ComplianceS C Analyses <br /> ' WW=waste water SD=solid MoMonitMonitoringRequestedto <br /> ng a } ° r <br /> MW=monitoring well SO=sod m n <br /> HW=hazardous waste SL=sludge Y N p It V� <br /> I a <br /> ' TURNAROUND TIME REQUESTED e t <br /> Standard Lab Manager n fi <br /> US Approval y r <br /> r <br /> eaal p IS <br /> CLIENT'S SAMPLE IDC/LO ATION` Date y, Time e <br /> Spl No <br /> 11- 3 <br /> 1 <br /> Instructions/Comments/Special Requirements <br />' SAMPLE RECEIPT - <br /> D to Time Sampes Re nquished By Samples Re etved B <br /> Received Cold Y N �!< q' N-5-� <br /> Custody Seals Y N S it 1s L5 <br /> als Intact Y N <br />' No of Containers <br /> Acculabs'terms are Net 40 (Payment must be received by the date shown on the Invoice or any discount is void) <br />