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IAccredited 2773 Downhill Drive <br /> Environmental Steamboat Springs,CO 80487) lt��) l(�j • <br /> Testing (970)879-6590 (_ ` 1 <br /> Name: e� <br /> -�ef.S't� Address: <br /> Company: <br /> E-mail: c Telephone: <br /> Copy of . to: <br /> Name: { $. E-mail- mr ..x-�. <br /> Company- ITelephone: V0 3av- 2 63 <br /> Invoice to: <br /> EE-ma <br /> e- �S " ��.. AddressTE �S�pan : (��1't-'� o Q ?il: . {,.�. Telephone: O -X JR>2 a <br /> Copy of Invoice <br /> Name. Address: <br /> Company: <br /> E-mail: Tele hone- <br /> H 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 /> "NO"drw ACZ wO oontaot o•wd for furrow M4uotloo N—ithw-YES"nor"NO"1.YWb.W,ACZ wil proewd wNh h uwbd r.q wlysw,ww r Mi Y wp4W, wil M gwWi.d <br /> Are samples for SDWA Compliance Monitoring? Yes No <br /> If yes,please include s�taate fortes.Results will be reported to PQL for Colorado. <br /> Sampler's Name' Sampler's Site Information State Zip code Time Zone <br /> 1.or.t fo th.wAhwti.iy wd wiry.r W.—0..1 udw.Wrd tlst YrOrdbrWly mM1YN U"UnWdr.noo.Non w <br /> 'Samplers Signat _ 1w1p.rVV w•h Um am"in wryw.y,is oon.Wemd Mod wrd purd.h.ft by Ef.r L­ <br /> PROJECT INFORMATION <br /> Quote#: 124 <br /> PO#: <br /> Reporting state for compliance testing <br /> 0 <br /> Check box if samples include NRC licensed material? G <br /> • • e • :0 <br /> W-A z:L3 <br /> w S <br /> o <br /> y <br /> V <br /> �r <br /> Matnx SW(Surface Water) GW(Ground Water) WW(Waste Water) DW(Dnniung Water) SL(Sludge) SO(Soil) OL(Oil) Other(Specify) <br /> Please refer to ACZ's terms&conditions located on the reverse side of this COC. <br /> • / � • s � . <br /> o A )v. <br /> L7346@ftNQ6158K7 Revision#: 2 White-Return With sample. Yellow-Retain for your records. 77 f 24 <br />