2009-04-13_REPORT - C1980006 ‎(2)‎

• Permit No: C1980006
• IBM Index Class Name: REPORT
• Doc Date: 4/13/2009
• Doc Name: 2008 ARR Request for Assistance Memo
• From: Janet Binns
• To: Tom Kaldenbach
• Annual Report Year: 2008
• Permit Index Doc Type: Hydrology Report
• Email Name: TAK
• Media Type: D
• Archive: No

ACZ Laboratories, Inc. .
2773 Downhill Drive Steamboat Springs, CO 80487 [phone]
..
Name: ?r Address:
Company:
E-mail: C4, C.,nAlm_ rm?. Ale* Tele hone: o
Copy of Report
Name: E-mail:
Company: Tele hone: u?
Invoice
Address: Z7c
Name:
Company: Z
E-mail: C.4 nede t Telephone:
If sample(s) received past holding time (HT), or If insufficient HT remains to complete YES I^ I
analysis before expiration, shall ACZ proceed with requested short HT analyses? NO
If "NO" then ACZ will contact client for further Instruction. If neither "YES" nor "NO"
is indicated, ACZ will proceed with the requested analyses, even if HT is ex fired, and data will be qualified.
PROJECT INFORMATION • • (a ttaO list or use quote number)
uFQ_UOte #: O V
Pro'ect/PO #: c
Reporting state for compliance testing ,

cg
Sampler's Name: ?` •'
Are any Sam les NRC licensable material? °
.
1 r
A? ??' 3 5

Matrix SW (Surface water) • GW (Ground Water) WW (Waste Water) • DW (Drinking Water) SL (Sludge) • SO (Soil) • OL (Oil) • Other
REMARKS/ • DISCLOSURES

PAGE
of
Please refer to ACZ's terms & conditions located on the reverse side of, this COC.
RELINQUISHED BY. 1DATE.TIME RECEIVED BY. 1

fRMAD050.03.05.02 White - Return with sample. Yellow - Retain for your record?age 10 O 11.