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F8733 Rey, C <br /> AcculabsE Inc. Lab Number <br /> 1646 Olive Drive Davis CA 95616 530-757-0920 Fax 753-6091 <br /> ]7 Suttle St Durango CO 81301 970-247-4220 Fax 247-4227 Report <br /> rt ]4663 Table Mountain Dr Golden CO 80403 303-277-9514 Fax 277-9512 Due Date <br /> ]992 Spice Islands Dr Sparks NV 89431 775-355-0202 Fax 355-0817 <br /> nt ( / Fax Results Y N Page of <br /> Address <br /> Gln 3'�ra�a�arc:,• <br /> - - 1 PURL WA7�R 3UPP1JI�NFORMAT,IO�N <br /> City,State&Zi t r { x �]t - U System Name <br /> Contact � '1 � � /�. f <br /> 1 PWS No Report to State/EPA Y N <br /> Phone f - Collector's Name11 <br /> `r ��l Y�r�� POE No DWRNo <br /> (c <br /> Fax r)1A_C Project Name,,/),J L 7 r Collection Point <br /> P O Number Project Number? 17% ! ?� �' r� + City County <br /> PE,CODES -0S sAnalyses ) <br /> _ - t CV <br /> DW=drinking water T8=travel blank Compliance J <br /> P rn - r�n� Requestse <br /> w r �i <br /> t \ <br /> WW=waste water SD=solid Monitoring J,PIT SY <br /> MW=monitoring well SO=soil <br /> Y Ne <br /> HW=hazardous waste SL=sludge =r:1 ;n'l` <br /> JOhl ARO�Uf DT1MEREQUSTEd` -': 3 <br /> Standard Lab Manager r y <br /> Approval <br /> Special " "' {rt, f <br /> ]�,=Wf"" �Si�MA�� l7��` l � "ttrtei 3 �ma r <br /> _ , I" � „DBfe __ Spl No <br /> k �C-Itj h4 vj IL4, <br /> J0-9tAJ Cif 3 <br /> s� <br /> 1 <br /> r�:n,t,,,tions/Comments/Special Requirements <br /> fCSAMPLE CEIP,T� s r a�t Date ' Time* F > Sam-lei Reiingisished By `4�mptes`Received By.r ;, <br /> 1jecelvedCold Y N <br /> Custody Seals Y N <br /> Seals intact Y N <br /> eAc <br /> of Containers <br /> cuiabs, Inc '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 lima the IiabiWy ofAcculabs, Inc for the Client s damages to the total compensation <br /> eceived unless other arrangements are made in writing This limitation shall apply regardless of the cause of action or legal theory pied or asserted <br /> 301 2E <br />