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1 <br /> F8733 EPV Q, <br /> Acculabs Inc. Lab Number Z -� 63 <br /> "o r <br /> 046 Olive Drive Davis CA 95616 530-757-0920 Fax 753-6091 <br /> 5 Suttle St Durango CO 81301 970-247-4220 Fax 247-4227 Report <br /> 663 Table Mountain Dr Golden CO 80403 303-277-9514 Fax 277-9512 Due Date <br /> 92 Spice Islands Dr Sparks NV 89431 775-355-0202 Fax 355-08117 <br /> Clien=T COP—'P Fax Results Y N Page of <br /> Address Q PUBLIC WATER SUPPLY INFORMAVON <br /> City,State&Zip System Name <br /> Contact PWS No Report to State/EPA Y N <br /> ' Pho Collector's Nam POE No DWR No <br /> Fazl�eProject NamEg% { �Z 17 Collection Point <br /> P O Number Project Number 1 U 1 �, �,07 itY County <br /> SAMPLE TYPE CODES S G Analyses <br /> ' DW=drinking water TB=travel blank Compliance m n Requests <br /> -waste water SD=solid Monitoring t <br /> I a <br /> -monitoring well SO=sod Y N a t <br /> HW= hazardous waste SL=sludge n <br /> tURNAROUNU TIME REQUESTED T e <br /> tanda Lab Manager y r <br /> ' R Approval g S 1 <br /> Special <br /> CLIENT'S SAMPLE IDILOCATION Date TimeSpl No <br /> KV0 — =7-bZ- <br /> =7-6Z SZ',3d MW 4AL at <br /> i' W k-3'.\2- p� <br /> 1 <br /> 1 Instructions/Comments/Special Requirements <br /> SAMPLE RECEIPT Date Time Sdinples Relinquished By Samples Received By <br /> Received Cold Y N <br /> ' Custody Seals Y N <br /> ? Seals Intact Y N <br /> No of Containers <br /> Acculabs,roc's 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 Accuiabs, 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 /> i <br />