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Laboratories, Inc. ~ <br />L ~ ~ ~ <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334-5493 <br />Name: ~ Address: <br />Company' ~ ~ <br />E-mail: y) tZ. Telephone: ?~- <br /> <br />Name: Email: <br />Company: Telephone: <br />Name: Address: <br />Compan <br />E-mail: Telephone: <br />If sample(s) received past holding time (HT), or If insufficient HT remains to complete YES <br />analysis bofore eaplration, shall ACZ proceed with requested short HT analyses? NO <br />ff "NO" then ACZ will contact client for further Instruction. Ii neither "YES" nor "NO" <br />Is indicated, ACZ will proceed with the requested analyses, even i1 HT is expired, and data will be quallged. <br />.e e. e ~ a <br />C!UOSB #; i 1 <br />Project/PO #: ~^ ~ <br />Shippin Co.: ~ ~ _ <br />Trackin #: V T <br />Reporting State for compliance testing: o ~ J <br /># q. <br />a • e• <br />~ ~ <br />Q <br />W- .0 1 Gfu ~ <br />III- / 1t/ <br />w - X610 ~/ <br /> O G <br /> taro <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />MaUI>c SW (SUrlece Water) ~ GW (Ground Water) ~ W W:tWaste Water) ~ DW (Drinking Water) ~ SL (Sludge) ~ SO (Sd0 ~ OL (OII) • ONaT (S ~ ' ) <br />Qt.~,~, Cr.o..Q-~- gAC- C,fw-~ttSW -S PC.i° <br />t l~ l~G ~1 <br />• e e • k e • PAGE <br />r i ~a , <br /> <br /> <br /> <br />FRMOA021.06.03.05 Whirs - Retum wi8t sample. Yellow -Retain fur your records. <br />