2022-05-16_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: Hydrology
• Doc Date: 5/16/2022
• Doc Name: Water Monitoring - Surface Water
• From: Colorado Legacy Land
• To: WQCD
• Annual Report Year: 2022
• Report Quarter_Month: Mar
• Email Name: AME
• Email Name: MAC
• Media Type: D
• Archive: No

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ACZ Laboratories, Inc. ' -? •
2773 Downhill Drive Steamboat Springs,CO 80487 (800)334-�3
Name: Christie Blizinski
Address: 131 E. Lincoln Ave Ste.200
Company: Ensero Solutions Fort Collins, CO 80524
E-mail: [e-mail] Telephone: [phone],ext 229
Cc)py of Report to
Name: Evan Valencia E-mail:[e-mail]
company: Ensero Solutions Telephone: [phone]
Invoice to:
Name: Pauline Wong Adder: 131 E. Lincoln Ave Ste.200
Company: Ensero Solutions Fort Collins, CO 80524
E-mail: [e-mail] Telephone: [phone]
If sample(s)received past holding time(FIT),or if Insufficient HT remains to complete YES
analysis before expiration,shall ACZ proceed with requested short HT analyses? NO
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Are samples for SDWA Compliance Monitoring? Yes LW No
EMT-
If yes,please include state forms.Results will be reported to POL for Colorado.
Sampler's Name:EV.JW Sampler's Site Information state CO ZJp code 80401
Time zone MTN
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PROJECT INFORMATION
Quotem Ensero-2020
Pom 3100-P0205 E m
Reporting state for compliance testing: CO c (AH g m
U m m e
Check box If samples include NRC licensed material? 113
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SWAM 3-2-2022: 14:05 SW 8 ❑ ❑ ® ❑ ❑ © ❑ 103
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C Mahix SW(Surface Water)•GIN(Ground Water)-WW(Waste Water) DW(Drinking Water)•St.(Sludge)•SO(Soil)•OL(Oil) Other(Specify)
�roREMARKS
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This COC accounts for 16 containers. Shipped 3/2/2022
Please also send reports to [e-mail]
Please refer to ACEs terms 8 conditions located on the reverse side of this COC.
RELINQUISHED •.
FRMAD050 06.14.14 White-Return with sample Yellow-Retain for your records.
L71749-2205051128 Page 23 of 23