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AC Z <br /> Laboratories, Inc. • ' <br /> 2773 Downhill Drive Steamboat Springs,CO 80487 (800)334-5493 <br /> Name: Art Braun Address: 355 S. Teller St., Suite 200 <br /> Company: Braun Environmental, Inc. Lakewood, Colorado 80226 <br /> E-mail: braunenv@msn.com Telephone: 303-988-7697 <br /> Copy of Report <br /> Name: NA E-mail: NA <br /> Company: NA Telephone: NA <br /> 'Invoice to: <br /> Name: Art Braun Address: As above <br /> Company: Braun Environmental, Inc. <br /> E-mail: braunenv@msn.Com Telephone: <br /> If sample(s)received past holding time(HT),or if insufficient HT remains to complete YES <br /> analysis before expiration,shall ACZ proceed with requested short HT analyses? NO x <br /> If"NO"than ACZ will contact client for further instruction.If neither"YES"nor"NO"Is indicated,ACZ will proceed with the requested analyses,even if HT Is expired,and data will De qualified <br /> Are samples for SDWA Compliance Monitoring? YesLai No 0 <br /> If yes,please include state forms.Results will be reported to PQL for Colorado. <br /> Sampler's Name:A. Braun ors Site Information State CO Zip code 80813 Time Zone M <br /> 'l arrest to the if and validity of this sample.l understand that mislalxling the timeldale/locatien,or tampering <br /> A Bra ' / <br /> a Sampler's Signature: ,r'�"- with the sample in anyway,is considered fraud and punishable by state Law. <br /> PROJECT •' • <br /> Quote it: CC-ABA-Analysis per Quote <br /> d <br /> Po#: MH-01 <br /> 'ro <br /> Reporting state for compliance testing NA o <br /> u <br /> Check box if samples include NRC licensed material? ❑ 0 <br /> IDENTIFICATIONSAMPLE <br /> 060514-1 7/3/14:8:05am SO 1 ❑ ❑ ❑ ® I ❑ ❑ ❑ r <br /> 060514-2 7/3/14:8:25am SO 1 ❑ I ❑ ❑ ❑ ❑ ® ❑ ❑ <br /> 060514-3 7/3/14:8:33am SO 1 0 ❑ ❑ ❑ ❑ ❑ 0 <br /> 7�7�_ <br /> 060514-4 7/3/14:8:47am SO 1 ❑ ❑ ❑ ❑ ❑ 0 <br /> 060514-5 7/3/14:8:58am SO 1 ❑ ❑ 0 I 0 17 El rl El <br /> ® ❑ ❑ ❑ ❑ ❑ <br /> 0 0 D 0 ❑ 01 <br /> 0 <br /> DID 0 0 0 DID <br /> 0 <br /> --f� Matrix ISW(Surface Water) GW(Ground Water) WW(Waste Water) DW(Drinking Water) SL(Sludge) SO(Soil) OL(Oil) Other(Specify) <br /> REMARKS <br /> 4. <br /> --- o <br /> --- c <br /> --tn <br /> �at <br /> refer to ACZ's terms&conditions located on the reverse side of this COC. <br /> RECEIVEDRELINQUISHED BY: DATEJIME • , <br /> ✓ — 7 <br /> FRMAD050.03.14.13 White-Return with sample. Yellow-Retain for your records. <br /> L19264-1407281030 Page 12 of 14 <br />