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F8733 Rey <br /> Acculabs Inc. Lab Number <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 Report <br /> [ ]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 /> _77 Client Fax Results Y N Page of <br /> Addressi 'UBLIC WATER SUPpI:Y INFORMATO` <br /> City,State 8 Zip ;! C yrcll ( 1 System Name <br /> Contact f PWS No Reportto State/EPA Y N <br /> Phorle� o lectbU Name5�- n POE No DWR No <br /> Fa4 — ~ r fect Named Collection Point <br /> P 0 Number Project Number p,iG�P�C�f � T OZZ ity County <br /> Y w <br /> SAMPLE TYPE CODE�S� Aw- <br /> a <br /> s Analyses <br /> 1 DW=drinking water TB=travel blank Compliance Requestewaste water SD=solid Monitoring r3 <br /> MW= onitoring well SO=soil Y N <br /> HW=hazardous waste SL=sludge r n� <br /> ,TURNAROUND TIME REQUESTED, <br /> Standard Lab Manager <br /> R Approval ate' S T <br /> e <br /> Special e, <br /> CLIENT'S SAMPLE IDILOCATION 4` Date Time :" Spl No <br /> VV Vl} <br /> -\\s N VJ X <br /> K 3 <br /> iinstructionsIComments/Special Requirements l <br /> SAMPLE RECEIPT rr Date Time Samples Relinquished By ampler Received By <br /> Received Cold Y N if �j <br /> t' <br /> Custody Seals Y N <br /> eals Intact Y N <br /> jNo of Containers <br /> Acculabs, 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 limit the liability of Acculabs,Inc for the Client's damages to the total compensation <br /> 1eceived 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 />