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Laboratories, Inc. L~2Z~ ~ ' <br />2773 Downhill Dr/ve Steamboat Springs, CO 80487 (800) 334-5493 <br />• ~ ~ <br />.. <br />Name: C•~~ Q,, Address: ~. 4 <br />`p ~ c~ <br />Company: I <br />E-mail: Telephone: ti~- <br />.. <br />Name: E-mail: <br />Company: Telephone: <br />Name: Address: t7t Q~ <br />Company: tlt/tL 1 <br />E-mail: MG At Telephone: <br />H sample(s) received past ho ding time (HT), or if Insufficient HT remains to complete YES <br />anatysis before expiration, shall ACZ proceed with requested short HT analysas7 NO <br />If "NO" then ACZ will contact client for further Instruction. If neither "YES" nor "NO" <br />Is indicated, ACZ will proceed with the requested analyses, even if HT Is ozpired, and data will be qualified. <br />•e s- • • ~ <br />l0 <br />ProjecUPO #: O~ o~ a~ Q OZ <br />c .~ <br />Shipping Co.: ~ •,~ <br />Tracking #: o <br />Reporting State for compliance testing: `o ~~ + <br />i! 3 <br />e e s~ ~~ <br />d~ ~ 2 i ~~ <br />Dts2 ae o3' G'~ <br />Q 30 03: ; O GW <br /> 30 03= ~Sa <br /> 3o v3= <br /> <br />I Aft ~D 0~~ SOB <br /> <br /> <br /> <br /> <br /> <br />Melnx SW (SUdace Water) ~ GW (Ground Water) ~ W W (Waste Water) ~ DW (Dunking Walar) ~ sL (SluAge) ~ SO (Soil) ~ OL (OII) ~ ONer (Specify) <br />• ~ s ~ ~ : ~ ' PAGE <br />.'S I o3 10;30 <br /> OF <br /> <br />L <br />FRMOA021.06.03.05 <br />White - Retum with sample. Yellow -Retain for your records. <br />IA2294: Page 28 of 28 <br />