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UW0 <br />AGZ Laboratories, Inc. <br />2773 Downhill Ddve Steamboat S rigs, CO 80487 (800)334-5493 <br />yy111 PII <br />E-mail: ` s Telephone: ]Z& <br />Copy . Report to: <br />Name: 7E-mall: <br />Com an : -S L elephone: <br />• Address: <br />(AS-- AA5VA:)- <br />Name: <br />Com an <br />El: Telephone: <br />N 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 "YES" nor "NO" <br />In Indicated. ACZ will proceed with the requested analyses. even if HT is expired, and data will be qualified. <br />M <br />I/PO M <br />c <br />in state for com Hance testin : &ARAW <br />0 <br />er's Name: V <br />V samples NRC licensable material? A1/0 <br />C 141 A" <br />MAIN <br />y <br />Matrix SW (Surface Water) • GW (Ground Water), WW (Waste water) • DW (Drinicing water) SL (Sludge) • SO (Soil) • OL (Oil) • Other (Spo*) <br />.• <br />730 - 1 <br />Tbs I Tf N1MC <br />?A7?fi?(r Nei & ?'DML Lill */? <br />the reverse side of this COC. <br />Ain ? r . L&i ef4 z8/j S aigone Nei t &A <br /> <br />FRMAD050.03.05.02 White - Return with sample. Yellow - Retain for your records. <br />L60542: Page 14 of 14