2021-08-26_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 8/26/2021
• Doc Name: Water Monitoring - Surface Water
• From: Colorado Legacy Land, LLC
• To: DRMS
• Annual Report Year: 2021
• Report Quarter_Month: Jun
• Email Name: AME
• Media Type: D
• Archive: No

ACZ Laboratories, Inc. • "
2773 Downhill Drive Steamboat Springs, CO 80487 [phone] • " •
Ensero Solutions ACZ Project ID: L66559
3100-P0205 Date Received: 06/17/2021 11:12
Received By:
Date Printed: 6/18/2021
Receipt Verification
YES NO NA
1) Is a foreign soil permit included for applicable samples? X
2)Is the Chain of Custody form or other directive shipping papers present? X = _
3)Does this project require special handling procedures such as CLIP protocol? X
4)Are any samples NRC licensable material? I I 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 _
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? X _
11)For preserved bottle types,was the pH checked and within limits? 1 �x
12)Is there sufficient sample volume to perform all requested work? FxI _
13)Is the custody seal intact on all containers? F X
14)Are samples that require zero headspace acceptable? IX
15)Are all sample containers appropriate for analytical requirements? X
16)Is there an Hg-1631 trip blank present? [ X J
17) Is there a VOA trip blank present? X
18)Were all samples received within hold time? X
NA indicates Not Applicable
CustodyChain of
ShippingClient Contact Remarks
Cooler Id Temp(°C) Temp Rad(pR/Hr) Custody Seal
Criteria(°C) Intact?
--------- -------- ------------ ---------- ------------
6674 8.5 <=6.0 15 N/A
Was ice present in the shipment container(s)?
Yes - wet ice was present in the shipment container(s) but was thawed by receipt at ACZ.
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
L66559-2108181147 Page 21 of 23