Laserfiche WebLink
/qGZ Laboratories, Inc. L <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334-5493 <br />- • 1 • <br />Name: Com/ Address: <br />Com an : <br /> <br />j `- <br />E-mail: C aot? t'Jh t • Telephone: <br />.. . Report <br />E-mail: <br />Name: <br />??rr <br />Com an Tele hone: <br /> <br />Name: Address: <br />Com an : <br />r <br /> <br />/ <br />E-mail: e Q",I m .AJ Telephone: <br />or if insufficient HT remains to complete YES <br />le(s) received past holding time (HT) <br />If sam <br />, <br />p <br />shall ACZ proceed with requested short HT analyses? NO <br />sis before expiration <br />anal <br />, <br />y <br />If "NO" then ACZ will contact client for further instruction. If neither "YE S" nor NO <br />is indicated, ACZ will proceed with the re uested analyses, even if HT is expired, and d ata will be qu alified. <br />PROJECT INFORMATION REQUE STED (attach list . quo te <br />Quote <br />Project/PO c <br />Reporting state for compliance testin : <br /> <br />Sampler's Name: 53sm U <br />Are an sam les NRC licensa ble material? ° <br />SAMPLE IDENTIFICATION DATE.TIME, Matrix <br /> <br />*V2 <br />07 <br /> <br />G <br />I <br /> <br /> 3 V ) <br /> <br /> <br /> 'Db I <br /> i <br /> <br /> <br /> <br />Matrix SW (Surface Water) - GW (Ground Water) WW (Waste Water) DW (Drinking Water) - SL (Sludge) SO (Soil) OL (Oil) •' Other <br />REMARKS/ i SAMPLE'DISCLOSURES <br />PAGE <br /> <br />of <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC. <br />11111111101116113 i . i i . <br /> <br /> <br /> <br />FRNAD050.03.05.02 White - Return with sample. Yellow - Retain for your records. <br />L63744: rake 17 of 18