Laserfiche WebLink
0 <br />,0 <br />0 <br />ADZ Laboratories, Inc.UqctD I <br />2773 Downhill Drive Steamboat Sprigs, CO 80487 (800) 334-5493 <br />•aa a <br />Name: IOn �A:� A. S-r-eWl Address: Q }' <br />/ <br />Company: G® )4)cL �S IllG <br />eD 6ey5az <br />E-mail: f f L'B-m Telephone: <br />- <br />Copy of Report <br />Name: & - E-mail: <br />r <br />Company: Tele hone: - 2 -- <br />Invoice to:- <br />Name:P-k! Address: , Q / <br />15-23 <br />Company: &64D 1 1 OJ �D/IIG <br />_ eO 8,050 Z <br />E-mail: a aeirvm Telephone: - 9A_ <br />666 <br />If sample s) received past holding time (HT), or if insufficient HT remains to complete <br />YES <br />analysis before expiration, shall ACZ proceed with requested short HT analyses? <br />NO <br />If "NO" then ACZ vnll contact crient for further instruction. N neither'YES" nor -NO" is indicated, ACZ will proceed with the requested analyses, even if HT is expired, and dab will ba qualified <br />Are samples for SDWA Compliance Monitoring? Yes No <br />If yes, please include state forms. Results will be reported to PQL for Colorado. <br />Sampler's Name: i�Sampler's site Information State: ip cod Time Zone <br />Check box if observe Daylight Savings Time <br />PROJECTe' • ' (attach list or use quote number) <br />Quote #: <br />PO#: <br />' <br />Reporting state for compliance testing: 0 <br />1r <br />Check box if samples include NRC licensed material? <br />"S1.41.0 / S <br />D 131606 - M 14.'30 G W <br />3 <br />V- <br />✓ ✓ <br />✓ <br />✓ <br />0 6 1606-141J-5' '► 1 :2 0W <br />3 <br />�' <br />✓ ✓ <br />013i066 — RbLFj% tI 12%¢D �;W <br />3 <br />✓ <br />01 0 06 - 1 1 1 5w <br />3✓ <br />Matrix SW (Surface Water) - GW (Ground Water) WW (Waste Water) • DW (Drinking Water) • SL (Sludge) <br />SO (Soil) OL (Oil) • Other (Specify) <br />REMARKS <br />�LL l2}i�i S�}A�tPLCS� FiLTL7i� g 5 NG�',OPa , <br />A�VAZY� ,t=r�2 t�BDVE &2/5777-09_iV rs D <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC. <br />RELINQUISHEDD• <br />D• <br />o /3 4 , <br />o - 3 . <br />uVrA <br />FRMAD050.12.12.12 White - Return with sample. Yellow - Retain for your records. <br />Al— <br />VW <br />