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Laborataries, Inc. ~ ' <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334.5493 G „fOS • , <br />•.. <br />Name: Address: <br />Company: ~~ ~f0) <br />Email: Q ~w Telephone: 5- 2160 <br /> <br />.. -.. <br />Name: E-mail: V , ~ <br />Company: Telephone: -5 ~~ <br />Name: Address: <br />Compan <br />y: <br />nn <br />E-maik +f ( ~ Telephone: S ~f~ <br />If sample(s) reeelved past holding time (HT), or if insufficient HT remalna to complete YES <br />analysis before expiration, shall ACZ proceed with requested short HT analysea7 NO <br />If "NO" then ACZ will contact client for further instruction. If neither "YES" nor "NO" <br />is Indicated, AC2 will proceed with the requested analyses, even If HT is expired, and data will tw qualHled. <br />.~ ~. ~ s r <br />Quote #: ~ ~ ~- ; <br /> <br />Shi ping Co.: ~ ~ <br />c -~ <br />Tracking #: o <br />U <br />Reporting state for compliance testing: c <br />Are any samples NRC licensable material? W # <br />a • a. <br />w-c~a i 33 <br />r~t.o--cam id C~ <br />r~,t~--coo I ~3 S <br />vtn t.L~ -~ C 1 US 'I X <br />- I qov x <br /> Io 5 <br /> <br /> <br /> <br /> <br />Matrix SW (Surface Water) ~ GW (Ground Water) • WW (Waste Waler) ~ DW (Drinking Waler) ~ SL (Sludge) ~ SO (Soil) ~ OL (Oil) • Olher (Specity) <br />~n ~~ ~ <br />c~~ ;~. <br />~ ~+c¢ <br />. <br />S <br />a 1: t. r a y Page <br /> Of <br /> <br />FRMOA021.12.03.06 <br />White -Return with sample. <br />Yello to re <br />