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F8733 Bey- Q <br /> Acculabs Inc. Lab Number Z <br /> 1046 Olive Drive Davis CA 95616 530-757-0920 Fax 753-6091 <br /> 141 75 Suttle St Durango CO 81301 970-247-4220 Fax 247-4227 Report <br /> 1 ]4663 Table Mountain Or Golden CO 80403 303-277-9514 Fax 277-9512 Due Date <br /> [ ]992 Spice Islands Or Sparks NV 89431 775-355-0202 Fax 355-0817 <br /> ' Clients-� 1 Fax Results Y N Page of <br /> ClientoF` ' APUBLIC WATER SUPPLY INFORMATION <br /> Addre-a&-5—City,Stale&Zip ''7 -{��C� System Name <br /> Contac PWS No Report to State/EPA Y N <br /> Phon 5 G Collector's Nal" -7 POE No DWR No <br /> Fa 5 :3Vb p'$ Project Nam �1-70 I Collection Point <br /> ' P 0 Number Project Number 700ez>I Ci t Y, County <br /> SAMPLE TYPE CODES S C Analyses <br /> DW=dnnkmg water TB=travel blank Compliance M n Requests <br /> ' -waste water SO=solid Monitoring $ t <br /> t a <br /> W= nitonng well SO=soil I Y N e t <br /> ' HW=hazardous waste SL=sludge n <br /> TURNAROUND TIME REQUESTED T e <br /> Standar Lab Manager y r <br /> s <br /> RUSH Approval P <br /> e <br /> Special <br /> CLIENT'S SAMPLE&LOCATION Date Tame Spl No <br /> lit I I I I Ial <br /> NLW - �1 aZ oZ <br /> M <br /> Instructions/Comments/Special Requirements <br /> SAMPLE RECEIPT Date Time 4amples Relinquished By Samples Received By <br /> Received Cold Y N <br /> Custody Seals Y N 9 & tcS$ <br /> Seals Intact Y N <br /> No of Containers <br /> Acculabs, Ines Standard Terms and Conditions apply unless written agreements specify otherwise Payment terms are Net 30 <br /> 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 />