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Acculabs Inc. Lab Number <br /> [ ] 1725 W 17th St Tempe AZ 85281 602-967-1310 Fax 967-1019 z o <br /> [ ]4455 S Park Ave Tucson AZ 85714 520-807-3801 Fax 807-3803 Report <br /> [ ]2020 W Lone Cactus Dr Phoenix AZ 85027 602-780-4800 Fax 780-7695 Due Date <br /> [ ]2029 N 41h 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 ( ei- ec-lr.t #,L i h S C ,,, ` IPUBLIC WATER S6PP0Y-INFQRMATl01" 4''' <br /> P . <br /> � b �X a._� <br /> tAddress Cp , / /vtC�s t Z-3 0 System Report to State Y N <br /> City, State&Zip C !.�E-, e C f e-ti re S 6 2 2 3 4s PWS No Report to EPA Y N <br /> Contact ��/� /'sT� �� POE No DWR No <br /> Phone <br /> //��(-1"02,11— 17 3 Project Name Aj a -i T Collection Point <br /> Fax [G/ ��u'l— S/ -,?-C;;, Project Number 2-6V 4 7 Collectors Name <br /> P O Number Fax Results Y N Page of Location (City) <br /> SAMPLE TYPE CODES w _ _ Analyses <br /> DW=dnnking water TB=travel blank Compliance S G Requested <br />' WW=waste water SD=solid Monitoring m a o <br /> n ' <br /> MW=monitoring well SO=soil t <br /> HW=hazardous waste SL=sludge Y N P I a <br /> TURNAROUND TIME REQUESTED <br /> Standard Lab Manager T e e <br /> RUSH Approval Y r <br /> 'O 1 <br /> 5 <br /> Clal <br /> qWVCLIENTS SAMPLE IDIC&ATION Date Time � $� r ^ e4 � Spl No <br /> C P t-- 1 AI—'-s 17 / `f3o ter! � X ()I <br /> 1 T—( � A- 0450 w- S K Q <br /> C PT- I �7�- iso �94 /oio s,,,f ! AL, Lr— <br /> CEL I /060 trte ?C of <br /> C P-1 - 7-3 n-I-o <br /> Ice-r--z- 4-4- . tzs s it K 06 <br /> C p-r--2 G Q - 7 0 .s s,E I ! 07 <br />' C -- Z -73 4 Kds <br /> CS T- -1 34 - 3 -7 $-7144-0 sa,[ 1 - <br />' C P7-3 144 Fri i <br /> f o <br /> Instructions/Comments/Special Requirements <br /> SAMPLE RECEIPT ��� 'Date Tlme` Samples"Rellnqu hed B _ --'V% Sainp[es Received B _ <br /> Received Cold Y N <br /> 4austody Seals Y N <br /> ls Intact Y N <br /> No of Containers <br /> Acculabs'terms are Wit 40,(Payment must belreceived by the date shown-,On the Invgice or any discount is void) r <br />