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AC <br /> Laboratories, Inc <br /> ./// <br /> 2773 Downhill Dnve Steamboat S nn80,187 800 334115493� <br /> Name Bryan Lees Address 490 Orchard Street <br /> Company Colorado Calumet Co., Inc Golden, CO 80401 <br /> E-maii bryan@collectorsedge.com Telephone 303 278-9724 <br /> Co0y of Report to: <br /> Name Ben Langenfeld E-mail, blangenf@gmail com <br /> Campany, Greg Lewicki and Associates Telephone. 303 960-5613 <br /> Invoice to: <br /> Name. Bryan Lees Address. 490 Orchard Street <br /> Company Colorado Calumet Co., Inc. Golden, CO 80401 <br /> E-mail. bryan@collectorsedge com Telephone: 303 278-9724 <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 analvses0 NO <br /> If'NO'I—ACZ wr It.o next cnent for turthe,—t-1— n n,,the,'YES-nor'N:l',s t,el—ad,ACZ w 11 prxeed.-the I—It etl analyses e n f M''a earned,a tl data w,tl be qu lice <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: Langenfeld Sampler's Site Information State CO Zip code 80420 Time Zone MST <br /> -I attest to the wIh_n y and vandny of thn tamp:-i understand that mention al ty mnlahetm.the N me/date/1-1-1n or <br /> 'Sampler's Signature: tampee,ng with the sampler anyway,n co—dared fraud and pumshabte by state law <br /> P116JECTINFORMATION <br /> ouote# ABA-Static <br /> o� <br /> Po# N/A <br /> .a <br /> Reporting state for compliance testing CO p I <br /> ® U ry <br /> Check tox ifsamol=s include NRC licensed matena19 0 <br /> • • • # <br /> Waste Rock 06106117, 12-15 SO 1 ix i ❑ ❑ © ❑ ❑ 0 ❑ <br /> il. t ❑ DI ❑ ❑ ❑ ❑ I ❑ <br /> V I i ❑ © © ❑ 01 ❑ ❑ ❑ <br /> ❑ © ❑ ❑ <br /> El F-1 <br /> © © ® ❑ ❑ ❑ ❑ ❑ <br /> N Nia+ra S'sy(Surface water] G�'+'(Gr�)ur,d;^Dater) wvv(Vaaste Vlater; DJ!(Dr,nk ng V,ate-) S_(S jdge� SG(Scii, OL(mil; Otne, (Spe-tfy, <br /> Five points of the waste rock from a fresh blast were randomly selected, and a trowel-full from each <br /> ----- r� was added to the sample bag Large(>3") pieces were avoided <br /> y <br /> Please refer to ACZ's terms&conditions located on the reverse side of this COC <br /> • • . D : • • <br /> RELIN= ?,a1D _ _ ,-: IJhlt2 °•`t:,p. ;aric! Yellor-aq+air fo• l.0 ec,ords <br /> L 37726-i 7072816--'t Page 19 of 19 <br />