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ACZ Laboratories,Inc. <br /> 2773 D-,d.11 D—,siamn6o i Spnw,CO 90427 j*W)334-5493 L Y <br /> Name:Eric Simms Address• 3200 RBC 31 <br /> Company. Natural Soda,Inc Rifle,Colorado 81650 <br /> E-mad simmse rinaturalsods corn Telephone-970-878-3675 ext 13 <br /> Name:Michael Clark E-mail:clarkm@natur3isoda.com <br /> naturalsoda.com <br /> Com n .Natural Soda ITelephonc 970-878-3675 ext.25 <br /> Randy Dean I E-mail:rand .dean daubandassociates corn <br /> Corn n Daub and Associates [Telephone 970-254-1224 <br /> Name:Adam Chambers E-mail,adam.chambers daubandassociates com <br /> Com Daub sad Associates Telephone:970-254-1224 <br /> Name Jeff Pans E-mail:jeff.paris@daubandassociatcs corn <br /> Company:Daub and Associates Telephone.970-254-1224 <br /> Name. Halene Burklow E-mail: AccountsPa able/laNaturalSods.com <br /> Company, Natural Soda,Inc Telephone: 970-878-3674 ext 22 <br /> If samples)received past holding vine(HT),or if msuflScieni HT remains to complete YES X <br /> analysis before expiration,shall ACZ proceed with requested short H r analyses? NO <br /> if"NO"then ACZ will contact client for further instruction If neither"YES"nor"NO" <br /> is indicated,ACZ will proceed with the requested analyses,even if H I is expired,and data will be qualified <br /> Quote H p <br /> O! C <br /> ProjecvPO <br /> Reporting state for compliance testing c 3 3 e <br /> Are any samples NRC licensable material? NO U `; U <br /> m <br /> O rA to W <br /> x z z GC t4- <br /> ALL SAMPLES ARE UNFILTERED <br /> 89-1 3/10/2015 12:00 3 X <br /> 789-2 3/10/2015 14:25 3 X <br /> BG-5 3/10/2015 15:30 3 X <br /> DS-5 3/10/2015 15:55 3 X <br /> 2-C 3/10/2015 16:00 3 1 X <br /> DS-3 3/10/2015 16:45 1 3 X <br /> C Matrix: SW(Surface Water)G W(Ground Water)W W(Waste Water)DW(Drinking Water)SL(Sludge)OL(Oil)Other(Specify) <br /> N C <br /> �y <br /> Please send back cooler. <br /> Please send replacement bottle sets. <br /> 3/11/2015 11:00 AM <br /> DAVID STEWART 3/11/2015 <br /> FRMAD050 09 04.01 <br /> Figure 4.Sample Chain of Custody Form. <br /> Daub&Associates, Inc. Page B-7 Natural Soda LLC 2022 SAP <br />