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L? <br />W ACZ Laboratories, Inc. .,?. • <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334-5493 %61 ' <br />i Name: L-11VA A. C O L L I N S Address: 5oX 19 T5 <br />Comp pC1 t pyAL VAN IVES Pao 1 der CO 80 <br />3Z <br />E-mail: 11 VI&SUSIA?-SS n- '1 • CO(!?') Tele hone: 42 565" - <br />SW 4* P? 2Lr r Gc? ? <br />> DOW E5. Sw a N Z E-mail: 41 <br />ALE ?l j e- Tele hone: <br />QS <br />Name: Address. <br />Com an : u 3 R C LLG <br /> <br />E-mail: Telephone: <br /> <br />or If Insufficient HT remains to complete YES <br />ast holding time (HT) <br />ived <br />l <br />If <br />, <br />p <br />e(s) rece <br />samp <br />roceed with requested short HT analyses? NO <br />shall ACZ <br />iration <br />f <br />i <br />l <br />b <br />p <br />, <br />ore exp <br />e <br />ys <br />s <br />ana <br />If "NO" then ACZ Will contact client for further instruction. If neither "YES" nor "NO" <br />is indicated, ACZ Will proceed with the re ested analyses, even if HT Is expired , and data will be alified. <br />PROJECT INFORMATION ANALYSES REQUESTED (attach list or use quo <br />num <br />te <br />ber) <br />uote #: T ly - K0lj I r012l1JG 12 <br />Project/PO #: c <br />Reporting state for compliance testinq: CIO <br />Sam ler's Name: LWA GaLLI NS <br />Are an sam les NRC licensable material? N Q o <br /> <br />o9js?? 1 915108 1I:35 Gw 2 <br />p IS- W2 11; 20 Gb? Z <br />115 r 1N3 15iw 11.05 G Z <br />0080R15- W 10--55- GW <br />15- 14 A.- 9 /SIol 15:05 GW 2 <br />009 0315- W 06)d 1.5126 GW Z <br />0080915 - LH ?' 15)c6 9:25 SW 2 <br />0120915-- POND 9 /6/q8 10:25 5 2 <br />0080515- owl 01510 11.145* (;W 2- <br />00109.1Z- tj . 977? - ap 1 h " L 2 -- <br />Matrix SW (Surface Water) • GW (Ground Water) • WW (Waste Water) • DW (Drinking Water) • SL (Sludge) • SO (Soil) - OL (Oil) • Other <br />f 1 eau, 522, cd+tAC.j &t n w,,A A ; p"& &Z C h 0 C?i? n?? of <br />'v"Ori, lays- Sc?-fl,i+?+?? <br />Please refer to ACZs terms & conditions located on the reverse side of this COC. <br />W, RELINQUISHED BY: DDATE.-TIME RECEIVED BY, D. <br />?/ 9J51d9 ?:3Q Ll'P?-? ,,r?(nr.f? 15 aB 3;?9 <br />FRMAD050.03.05.02 White - Return with sample. Yellow - Retain for your recordeage z / OT Lzs