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ACZ <br /> Laboratories, Inc. <br /> LR�):D. <br /> • . <br /> 2773 Downhill Drive Steamboat Springs, CO 80487 (800)334- <br /> Name: L AU �U o Address:f(00 A- lLIL (�Wb, SUITE 21 % <br /> Com an A RICAD1 —VS L- KEWOb C�D,l q3o vl <br /> E-mail:LAQRI.VV I<C G RCA II-5-K (,vM Tele hone 3 2- 1 -9i 15 <br /> Copy of Report to: <br /> Name:TRECK J4 014 M E-mail: V4<.OC44 p, RCAc�IS-V ,Ca-M <br /> Company: ARCM 15-US Tale hone:Invoice - <br /> . <br /> Name:AC-(P0WV3 PA :A61Z Address:l'p b PLArIA bA , spyrt iot> <br /> Company: ' 1 S -V Nt u,N N `3617 i9 <br /> E-mail: c�'� ' t r Telephone: <br /> If sample(s)received past holding time(HT),or if insufficient HT remains to complete FITAOIE WNrF1(X% YES <br /> analysis before expiration,shall ACZ proceed with requested short HT analyses? LAU,Q 1 '1j.(jSj<,J NO <br /> It"NO"then ACZ will contact client for further instruction.N neither"YEV nor'NO"is indicated,ACZ will proceed with the requested analyses,even if HT is expired,and dab%ill be quallHed <br /> Are samples for SDWA Compliance Monitoring? Yes No ix I <br /> If yes,please include state forms.Results will be reported to PQL for Colorado. �A <br /> Sampler's Name: RUDE Sampler's site Information State: CJD Zip code Time Zone MT <br /> t <br /> Check box If observe Daylight Savings Time A <br /> PROJECT • - • r(attach list or use quote number) <br /> Quote#.11c7L(,iM 5NoRT i u1 -Ci o1 C lrw-T--E`.201`{�(sv�i 2 t I <br /> Po#:avoi. St0, %t7t �l <br /> � 3 <br /> Reporting state for compliance testing: Co c <br /> V # <br /> Check box if samples include NRC licensed material? w <br /> N <br /> IDENTIFICATIONSAMPLE • • cJ <br /> 14 13:f'5- CAWX. <br /> MW- 3 MIt 12;�I 3 <br /> 0 <br /> Matrix SW(Surface Water.) GW(Ground Water) WW(Waste Water) DW(Drinking Water)-SL(Sludge) SO(Soil) OL(Oil)-Other(Specify) <br /> -C REMARKS <br /> s� <br /> s <br /> �n <br /> �J <br /> Please,p6fer to ACZ's terms&conditions located on the reverse side of this COC. <br /> RELINQUISHEDD• D. <br /> FRMAD050.12.12.12 White-Return with sample. Yellow-Retain for your records. <br />