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Www Azdhs Govpreparednessstate LaboratoryAZDHSState Laboratory Arizona Department of Health Services Form

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Applicant does not have current certification Fee authority is prescribed at A. R.S. 3-146 Commodity or Sample-type OWNER S NAME STREET ADDRESS PHONE Activity E-MAIL I attest under penalty of perjury that the information contained in this application is true to the best of my information and belief. A. R*S* 13-2702 A 2 OWNER S SIGNATURE DATE MANAGER S SIGNATURE DATE For the period beginning and ending. Date Received Date Completed Deny Agency Action Taken Approve Authorized Signature Date Rev*...

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