2019-05-29_PERMIT FILE - M2019031 ‎(7)‎

• Permit No: M2019031
• IBM Index Class Name: Permit File
• Doc Date: 5/29/2019
• Doc Name: Application
• From: Atlas Mining and Reclamation LLC
• To: DRMS
• Email Name: THM
• Media Type: D
• Archive: No

ADZ Laboratories, Inc. _ ' •
2773 Downhill Drive Steamboat Springs, CO 80487 [phone] •
.eardon Steel LLC ACZ Project ID: L49791
Date Received: 02/07/2019 14:19
Received By:
Date Printed: 2/8/2019
YES NO NA
1) Is a foreign soil permit included for applicable samples? I X J
2) Is the Chain of Custody form or other directive shipping papers present? EXE
3)Does this project require special handling procedures such as CLP protocol? X -_
4)Are any samples NRC licensable material? F X
5) If samples are received past hold time, proceed with requested short hold time analyses? X
6) Is the Chain of Custody form complete and accurate? X
7)Were any changes made to the Chain of Custody form prior to ACZ receiving the samples? X
A change was made in the Relinquished by: Date:Time section
prior to ACZ custody.
YES NO NA
8)Are all containers intact and with no leaks? x
9)Are all labels on containers and are they intact and legible? X
10)Do the sample labels and Chain of Custody form match for Sample ID, Date, and Time? f 7'
11) For preserved bottle types,was the pH checked and within limits? 1 -T -FX
12)Is there sufficient sample volume to perform all requested work? X
13) Is the custody seal intact on all containers? X
i
14)Are samples that require zero headspace acceptable? X
15)Are all sample containers appropriate for analytical requirements? X
16) Is there an Hg-1631 trip blank present? F X
17) Is there a VOA trip blank present? F X
18)Were all samples received within hold time? E X
NA indicates Not Applicable
CustodyChain of
Shipping
Cooler Id Temp(°C) Temp Rad(uR/Hr) Custody Seal
Criteria('C) Intact?
NA29988 4.7 NA 16 N/A
Was ice present in the shipment container(s)?
No - Wet or gel ice was not present in the shipment container(s) .
Client must contact an ACZ Project Manager if analysis should not proceed for samples received
outside of their thermal preservation acceptance criteria
REPAD LPII 2012-03
L49791-1902271021 Page 25 of 27