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ACZ Laboratories, Inc. �� ��2CHAIN of CUSTODY <br /> 2773 Downhill Drivie Steamboat Springs,CO 80487 (800)334-5493 <br /> Report <br /> Name: 1 Address: 1 Oaf)') fi'. <br /> Com n : 60 l•-t C. 60 12 t 7 <br /> E-mail: /ii Ur(e. 6iV1Telephone: ( 20 <br /> Copy of Report to: <br /> Name: z ''/Y)//G fit�2 S <br /> Company: Tele hone: t cSHiL v✓1 C <br /> Invoice to: <br /> Name: Address: <br /> Company: <br /> E-mail: V Telephone: <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 analyses? NO <br /> It'?IO-than ACZ will"Most ebsnt for/urlhar insbuetien.N neither"YES"nor*NO"Is ledlossed,ACZ vAll proesed wilh Ow requested arrrysss,wen PINT Is sxplr",and data will be qualMled <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: uZ- Samplers Site Information State ed Zip code 05 D Time Zone <br /> •I attest to tb•■uth—batty and validity a1 this sample.t understand tlrl lnlenlbnNly m IlbslinS the timaidabAseallen or <br /> Samplers Signature: larriWaS vAlh Uw sample In anyway,is considered fraud end punishable by Stall L­ <br /> PROJECT INFORMATION <br /> Quote MAW, XA1VUtr,* <br /> m <br /> PO#: <br /> Report n state for com lian testing: 9,51p v Q <br /> Check box if samples include NRC licensed material? o S <br /> 0 • r ih <br /> - t In•1 5 Sw 0 <br /> 0 i <br /> lA <br /> =�= rix SW(Surface Water) GW(Ground Water)•WW(Waste Water) DW(Drinking Water) SL(Sludge) SO(Soil) OL(Oil)•Other(Spec <br /> r <br /> Please refer to ACZ's terms&conditions located on the reverse side of this COC. <br /> RELINQUISHEDDATE-TIME Dr <br /> LPA(y1 a311fA10 White-Retum with sample. Yellow-Retain for your records. Page 31 of 31 <br />