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1 <br />1 <br />ACZ Laboratories, Inc. <br />2773 Downhill Drive Steamboat Sminos. CO 80487 (800) 334 -5493 <br />1 <br />1 <br />IREPAD.04.06.05.01 Page 1 of 2 <br />L22988- 1503051058 Page 22 of 22 <br />Account: <br />GOLDER/Golder Associates <br />Bill to Account: Bill to ACZ <br />' <br />Bottle Order: <br />B032883 <br />Ship Date Requested: 02/05/2015 <br />Size Filter/Raw/Preserve <br />Internal Note: <br />1 GREEN <br />Request Placed at: 02/03/201511:15 <br />Metals (dissolved except ICPMS) - Filter sample with .45 micron <br />Service Requested: Ground <br />Sampling supplies <br />500 ML Raw <br />Wet Chemistry (analyses that do not require preservative or <br />filtration) - Completely fill container. <br />1 WHITE <br />PACK * Qty <br />ACZ ID <br />Type 4106MWMMWM <br />Description <br />2 <br />COC <br />Chain of Custody <br />Chain of Custody, 1 for 10 samples. <br />2 <br />SEAL <br />Custody Seal <br />Custody seals for cooler, two for each cooler. <br />' <br />1 <br />RETURN <br />Return Address <br />Return Address label, one for each cooler. <br />30 <br />LABELS <br />Sample Labels <br />ACZ supplied labels for sample containers <br />1 <br />1 <br />IREPAD.04.06.05.01 Page 1 of 2 <br />L22988- 1503051058 Page 22 of 22 <br />Quote number: HOLCIM -GW <br />Holcim Groundwater Monitoring <br />Sample Quantity: 10 <br />Client is responsible for necessary field filtering <br />PACK Qty Typ e <br />Size Filter/Raw/Preserve <br />Instructions <br />1 GREEN <br />125 ML FilteredfNitric <br />Metals (dissolved except ICPMS) - Filter sample with .45 micron <br />filter. Do not overfill as there is Nitric Acid in the bottle. <br />1 RAW <br />500 ML Raw <br />Wet Chemistry (analyses that do not require preservative or <br />filtration) - Completely fill container. <br />' <br />1 WHITE <br />250 ML Filtered <br />Wet chemistry (dissolved) - Filter sample with .45 micron filter. <br />Completely fill container. <br />1 <br />1 <br />IREPAD.04.06.05.01 Page 1 of 2 <br />L22988- 1503051058 Page 22 of 22 <br />