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Get SC DHEC 2802 2012

(New Lab) __ Additional Parameter Certification __ Due to PT Failure __ Recertification (Lab Previously Certified) EPA Lab Code _ _ _ _ _ _ _ Assigned S.C. Laboratory I.D. # _ _ _ _ _ Old SC Laboratory I.D.# _ _ _ _ _ B. Laboratory Name: C. Mailing Address (P.O. Box or Number and Street) (City) (State) (Zip Code) (State) (Zip Code) (State) (Zip Code) D. Physical Address: (Number and Street) (City) (County Code Number) E. Billing Address (for Certification Fees): (Billing Name) .

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