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UZ Laborafiories, I c. • <br />Downhill Drive Steamboat Springs, CO 80487 (8 O) 334549 <br />`.� <br />e: �1� � Address: l Z%-S0 J ✓A <br />pan y: _ GOiil. CO LLAC vii 1-V A) C>0 9510 <br />lil: .."I'rC0V_-4 ep- I h2- tt1 it 0e&AI 40.1 Telephone: 30 3 ^ .300 ' BE <br />E -mail: <br />E -mail: 14ACY (2 tJVJV44 0U , Coo9 I I Telephone: <br />If sample(s) received past holding time �(HT), or If ins <br />cient HT remains to complete <br />YES <br />analysis before expiration, shall ACZ p �oceed with re uested short HT analyses? <br />NO <br />If "NO" then ACZ MU contact ctleirt for further btstrucflon. If nelther'YES" nor "NO" <br />s Indicated, ACZ wUl proceed with Mae requested analyses, even N HVIs expired, and data wUl be qualNied <br />Are samples for SDWA Compliance Monitoring? <br />Yes <br />No <br />If yes, please include state forms. Results will be re <br />rted to PQL for Colorado. <br />Sampler's Name: 1A V Sampler's site in ormation State: GQ <br />Zip code Time Zone <br />Check box if observe Daylight Savings Time <br />PROJECT •- • <br />• (attach Hsi or use quole numbei) <br />Quote #: <br />Reporting state for compliance testing: I <br />p !� <br />Check box if samples include NRC licensed material? <br />a • s <br /># ` <br />Rod D ' o : 3 <br />S <br />✓ <br />rc.- D1Se1. Llpf- <br />0 <br />u <br />= Matrix SW (Surface Water) GW (Grow <br />e <br />-er <br />Lti4 5 iE' IEE7vw_ <br />Water) • WW Mesta Water) • DW (Drinking Water) • SL (Sludge) • SO (Soil) • OL (OII) • Other (Specify) <br />Please refer to ACTS terms &condition located on the reverse side of this COC. <br />L V , is I <br />FRMAD050.12.12.12 White 1 Return with s I mple. Yellow - Retain for your records. <br />