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~~~~~ <br />~ ' <br />Z <br />Laboratories, Inc. <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800J 3345493 <br />t ~ <br />n '/ <br />Name: F1 e/'SO,J Address: ® c-~Ok <br />Y- <br />~ 9 <br />~~yy <br />~~tt <br />Company: <br />{-~~ t~f~l l ZZ~~ <br />!!++ /~ <br />E-mall: G`Y Prt" M 1 .117GT' Telephone: - (p ,$~ <br />Name; 6.... ~ E-mail: <br />Compan : Tale hone: <br />Name: C>~~ Erna ~El ~-~'e1'S k7CC tASA. Ca'+~ <br />Corn an : ~ Telephone: ~7~-78~~ <br />If sample(s) receivetl past holding time (H~, or if insufficient HT remains to complete YES <br />analysis before expiration, shall AC2 proceed with requested short FfT analyses4 NO <br />if "NO" then AC2 will contact client for further instruction. It neither "YES" nor "NO" <br />is indicated, AC2 will roceed wkh the requested analyses, even If HT Is expired, and data will be qualified. <br />• e• ~ • r <br />00019 ~: Q ~ V ~ W <br />m <br />b <br />Re ortin state forcom liancetesting: a <br />U <br />Are any samples NRC licensable material? `o <br />r • r• m <br />© .Zf 61,J ?C <br />- ' f I,'o <br />3 ~~ <br /> <br />_ >r 3: v rr. ~ <br /> ! I ,' 8 w G>J <br /> -Z ~' -!~v y... <br /> <br /> <br /> <br />Matrix SW (Surface Weler) ~ GW (GrourM Wafer) ~ W W (Waste Water) ~ DW (Onnking Water) • SL (Slutlge) • SO (SWI) ~ OL (Oil) • Other (Specify) <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC <br />~ r • ~ ~ <br />'-~ 'Sl Zc> oS ( <br /> <br />r- ~ <br />FRMAD050.09.04.01 White -Return with sample. Yellow -Retain for your records. L50701: Page 14 of ] 5 <br /> <br /> <br /> <br />1 <br />