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Laboratories <br />Inc. • • <br />, <br />L5B84 <br />3 <br />, <br />2773 Don+ArlB Dials Steamboat S s, CO 80487 (800 3345483 <br /> <br />Name: /~ y.s.~ l /gyp Atldress: (3 (3 S . v n,,., f l '~+ 2 / S~ <br />Com an : .k S ~ --~/ Q v- r d u o <br />E-mail: v •N • Wu />f ~ ~-` S7t~-7rA , c v • v r Tale hone: Jo f $ 6 G 9 V <br />Name: E-mail: <br />Com n : Tale hone: <br />Name: Address: <br />Com an : <br />E-mall: Tale hone: <br />If sample(s) received past Ialding tlme (HT), or If InsulfleleM HT remains to complete YES <br />analysts before exphatlon, shall ACZ proceed with requested short HT analyses? NO <br />If "NO" Men ACZ will confect client fef fuHher irlslructlon. N neither "YES" nor "NO" <br />Is indlesfed, ACZ will procwd wHh Ms nested anatyssa, awn N HT Is axplred, and defy will M quNNled <br />•a •• • e ~ <br />Quote#: 20•fHtL6-fDNa!'C-S/ i! OL <br />m <br />Pro'ecUPO #: ~ <br />Ra rtin state for com fiance tesOn ~ <br />E <br />Sam lets Name: t <br />Oi ~ <br />Are an sam les NRC licensable material? ~ <br /> <br />s • s~ <br />(3s ~6 fr;>e <br />z G <br />.1 <br />~t b <br /> <br /> ~~~ <br /> <br /> <br /> <br /> <br />Meatx SW (Surface Water) ~ GW (Ground Water) • W W (Waste Water) • DW lDMnking Water) ~ SL (Sludge) • SO (SoA) • OL (Oil) • qhw (SpecHy) <br />Please refer to ACZ's terms 8 conditions located on the reverse side of Mis COC. <br />s s a• a. <br />.~- w~~. / s9 /i.3 F ~,., <br /> <br /> <br />FRAAAD050.03.05.02 White - Retlun vriM sample. Yellow - Retain for your records. <br />L58843: Page 22 of 25 <br />