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ADZ Laboratories, Inc. <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334-5493 <br /> <br />Name: U dr O ^j Address: <br />Company: C7 ZZ <br />E-mail: CC?c4- hn t o hl?? Telephone: J a -- 6 3 <br />Copy of Report to: <br />Name: C'?T-SOS E-mail: $ AF-4'JSCrA.) 6± , ?',p x <br />Com an : AJLJ eC- Telephone: ?-798 2 <br />Name: • 5-1 P_, S Address: ;5,5x <br />Compan : ep u6 <br />7 <br /> <br />7 <br />E-mail: court c&. rti' L. A J C'j" Telephone: -71 <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 short HT analyses? NO <br />If "NO" then ACZ will contact client for further Instruction. If neither 'YET' nor "NO" <br />is indicated, ACZ will proceed with the requested analyses, even if HT is expired, and data will he qualified. <br />PROJECT INFORMATION REQUESTED (attach list or use quoto mimber) <br />Quote <br />w <br />Project/P0 #: <br /> <br />w <br />Reporting state for compliance testin : 0-it, C? <br />c <br />`` <br />Sampler's Name: J r SS A" v <br />w <br />Are any samples NRC licensable material? o <br /> <br />rix <br />SAMPLE IDENTIFICATION DATE:TIME Ma <br /> <br /> tt ;?,r 1J <br /> 0 <br />?k <br /> <br /> <br /> ?, i av +I 3 <br />_ 2- <br />7 3 tt ; va II 3 <br /> I <br /> I <br /> <br />Matrix SW (Surface Water) GW (Ground Water) WW (Waste Water) • DW (Drinking Water) • SL (Sludge) • SO (Soil) • OL (Oil) Other (Specify) <br />REMARKS <br /> <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC. <br />RELINQUISHED BY: ¦A RECEIVED BY: DATE:TIME <br />D z 3 °v4 - vb <br />6' a <br />10, Z4 ' Q <br />0 (o <br />, <br />FRMAD050.03.05.02 White - Return with sample. Yellow - Retain for your records. <br />Z, <br />L59598: Page 16 of 117