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Acculabs Inc. Lab Number I���b <br /> [ ] 1725 W. 17th.St.Tempe AZ 85281 602-967-1310 Fax 967-1019 Illl`I <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.4th.St. Flagstaff AZ 86004 520-774-7643 Fax 774-7648 <br /> [ J 1046 Olive Drive Davis CA 95616 530-757-0920 Fax 753-6091 <br /> ( ]75 Suffle 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 L dN PUBLICWATER SUPPLY INFORMATION <br /> Address System Report to: State Y N <br /> — City, State 1&1�Z_ip` ]� PWS No. Report to: EPA Y N <br /> Contact [v►t;1 I( -BO POE No. DWR No. <br /> Phone Project NameiAPC, LAST <br /> Collection Point <br /> Fax Project Number Collector's Name <br /> _ P.O.Number Fax Results Y N Page Z of Location (City) <br /> SAMPLE TYPE CODES Analyses <br /> DW=drinking water TB=travel blank Compliance S C Requested <br /> WW=waste water SD=solid Monitoring a o <br /> III n <br /> MW=monitoring well SO=soil Y N p t <br /> HW=hazardous waste SL=sludge 1 a <br /> TURNAROUND TIME REQUESTED e 1 <br /> n <br /> tandard Lab Manager T e 1 <br /> ApprovalTttr� y r <br /> p s <br /> Special a <br /> CLIENT'S SAMPLE IDILOCATION Date Time Spl. No. <br /> -5Axifl <br /> 3 it <br /> X 1XI I 1 1 13 <br /> 5 -Lb IS <br /> 5 - . XV1 16 <br /> 13 <br /> _ ld <br /> ��33 19 <br /> Instructions/Comments/SpecialRequirements: + 'I" MI A <br /> 5 ocK"r�J 9 <br /> SAM LE RECEIPT Date Time mples Re'n ui ed Samples Received B <br /> Received Cold Y N Y'-13`�`I iwo �- <br /> Custody Seals Y N <br /> Seals Intact Y N <br /> No.of Containers <br /> Acculabs'terms are: Net 40 (Payment must be received by the date shown on the Invoice or any discount is void) <br /> Iib repo r ` f) .311 Grlb � Z6� 76� <br />