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' 4 <br /> Acculabs Inc. <br /> Lab Number <br /> ( ] 1725* 17th St Tempe AZ 85281 602-967-1310 Fax 967-1019 O b <br /> [ ]4455 S Park Ave Tucson AZ 85714 520-807-3801 Fax 807-3803 Report <br /> t [ ]2020 W Lone Cactus Dr Phoenix AZ 85027 602-780-4800 Fax 780-7695 Due Date <br /> [ ]2029 N 4th St Flagstaff AZ 86004 520-774-7643 Fax 774-7648 <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 702-355-0202 Fax 355-0817 <br /> Client % P[1BLIG,WADER-SOPPL*INFORM 1OW <br /> Address System Report to State Y N <br /> ' City Slate&Zip 4p r aj 25;,:� PWS No Report to EPA Y N <br /> Contact G.qi. DP POE No DWR No <br /> Phone �Q Prafect Nam /d h <br /> Collection Point <br /> Fax � ProjecttNumber Collector's Name <br /> t P O Number Fax Results N Page of I Location(City) <br /> y FC Analyses <br /> 11 <br /> DW=drinking water TB=travel blank Compliance $ �=�, ; Requested <br /> WW=waste water SD=solid Monitoring <br /> m n <br /> MW=monitoring well SO=sod Y N <p t % <br /> HW=hazardous waste SL=sludge t t—' `E a"` <br /> TIlRNARQuN � IQ1JTiD e 4r <br /> 1 <br /> Standard Lab Manager <br /> Approval c ye s <br /> RUSH <br /> X81 � �Srr <br /> 4 b �Egt <br /> P 8 r <br /> CLIENTS SAIVI LEOLC?GI TI n a�a rit3e ry �' 3�, spl No <br /> 01 <br /> ' W-� !f tig A <br /> Oz- <br /> fJ 5 03 <br /> 04 <br /> 44 U <br /> Instructions/Comments/Special Requirements <br /> SAMPLEREC�[PT „ <y ', "z pate Tune ,Sail7ples!Reu x _ mpt <br /> Sa es ecelved B „ <br /> ' Received Cold Y N Wa4n tzco ` <br /> Custody Seals Y N <br /> �als Intact Y N <br /> No of Containers <br /> Acculabs'terms are Net 40 ,(Payment must be received by the date,sehown on'�the Involce,br any,discount is vord) <br />