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/'7C~ Laboratories <br />Inc a <br />, <br />. <br />2773 Downhill Orlve Sfeamboar Springs, CO 80487 (800) 334-5493 L ~{' ~ ~ <br />Name: ~ MORf2f5$~- Address: dd Z.5^gd <br />Com any: ClJ1JNFiGt- ,yS0~2c~$ J-.V SYer~t b~h~- ar.u s G~ Oy 8 ~ <br />E-mail: O'(, w0l/1 SSG (D,ua.P,( Y($Ovpo25, wl Telephone: q'70' 70- O 2 OQ <br />.. <br />Name: <br />E-mail: <br />Com any: Tale hone: <br />Name: ~ Email: <br />Com an : Telephone: <br />If sample(s) received past holding time (HT), or if insufficient HT remains to complete YES <br />analysis before expiration, shall ACZ proceed with requested shoR HT analyses? NO <br />if "NO" then ACZ will contact client for further instruction. If neither "YES" ttor "NO" <br />Is Intlicated, ACZ will proceed Wllh the requested analyses, even if HT is expired, and data will be qualified. <br />• a • • s • <br />r <br />Quote #: .,,( <br />w C '~ ~n <br />Pro'ecUPO #: W $. LL Sibhr Pr-/+'-S c r '~ [~°' <br />Reportin state for compliance testin o ~ ~ <br />C7 Z Q t- Y ` X <br />,_ ~ Ml <br />Are any samples NRC licensable material? ,.r r7 e ~ (-, o r, f' ~ <br />r • a~ ~ ° 601 <br />1~No~25oa W E~~ IoIS W! 083t~ GuJ ~ X >~ x x X X <br /> <br />-SLUd2 W~ti -a O~Os' GuJ x n r~ ri x x <br /> <br /> <br /> <br /> <br /> <br /> <br />Matrix SW (Surface Water) ~ GW (Ground Weler) ~ W W (Waste Water) ~ OW (Drinking Water) ~ SL (Sludge) ~ 50 (Soil) ~ Ol (Oil) • Other (Specify) <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC <br />• r a• a: a• <br />/~ / <br /> l,~a <br />I~ <br /> ~I y~ <br />, f ~ <br />ar~(S v <br />FRMAD050.09.04.01 White -Return with sample. Yellow -Retain for your records L48305: Page l S of l S <br /> <br />