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ACZ Laboratories, Inc. <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334-5493 <br />Account: GOLDER/Golder Associates <br />Bottle Order: B034388 <br />Bottle Order <br />Packing List <br />Bill to Account: <br />Ship Date Requested: <br />Request Placed at: <br />Service Requested: <br />Bill to ACZ <br />10/2612015 <br />10/23/2015 08:35 <br />UPS Ground <br />Sampling supplies <br />PACK Qty ACZ ID <br />1 <br />2 <br />1 <br />30 <br />COC <br />SEAL <br />RETURN <br />LABELS <br />Ty pe <br />Chain of Custody <br />Custody Seal <br />Return Address <br />Sample Labels <br />Description <br />Chain of Custody, 1 for 10 samples. <br />Custody seals for cooler, two for each cooler. <br />Retum Address label, one for each cooler. <br />ACZ supplied labels for sample containers <br />ACZ Coolers <br />PACK Qty ACZ ID <br />4632 <br />Size Weight <br />Large 11 <br />UPS Tracking Number <br />1Z8101300375073265 <br />Quote number: HOLCIM-GW <br />Sample Quantity: 10 <br />PACK Qty Type <br />1 GREEN <br />1 RAW <br />1 WHITE <br />Holcim Groundwater Monitoring <br />Client is responsible for necessary field filtering <br />Size Filter/Raw/Preserve Instructions <br />125 ML Filtered/Nitric <br />500 ML Raw <br />250 ML Filtered <br />Metals (dissolved except ICPMS) - Filter sample with .45 micron <br />filter. Do not overfill as there is Nitric Acid in the bottle. <br />Wet Chemistry (analyses that do not require preservative or <br />filtration) - Completely fill container. <br />Wet chemistry (dissolved) - Filter sample with .45 micron filter. <br />Completely fill container. <br />Prepared By/Date: <br />sh <br />L27730-1511231527 <br />Page 1. of 2 <br />Page 20 of 20 <br />