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<br />Ll nl P-n9 <br /> <br />ACZ Laboratories, Inc. ' <br />?773 Downh!!l Drive Steamboat S , CO 80487 800 334-5493 <br />Name: Address: P140,1 9 .6 <br />Com n pay:Admer E <br />E-mail: sW r / M .CDM Telephone: G- <br />f <br />Name:. &MAUJOArUX t;'' E-mail: ' <br /> <br />, <br />Com n : Tele hone: - 4 5- <br />Name: Address: <br />Com n : hIgUAlf LLC .0 <br />M <br />te <br />E-mail: Telephone: <br />M sample(s) received past holding Inn (HT), or If Insufficient HT remains to complete YES <br />analysis before expiration, shall ACZ proceed with requested short HT analyses? NO <br />H "NO" then ACZ will contact client for further Instruction. If neither "YES" nor "NO" <br />Is Indicated ACZ will roceed with there uested ana sss, even If HT is expired, and data will be ualifled. <br />PROJECT • <br />Quote 0: MOVES <br />P CtlPO <br />Reporting state for Com liance testin : <br />Sam pi" Name: v <br />° <br />Are an samples NRC licensable material? <br />M 11110111 <br />_W1 3 lr: &j <br />2 - W2. )j: 2o du 3 <br />OO 2 - W3 / : 55 Ai 3 <br />oo 29 - W? 3 i? •?0 3 <br /> <br />,004,0330- ?C -Po .//: Std <br />d 3 - HA 11: 20 s&? 3 <br />0070396 - C ta 3 <br />- PaJD ?1 <br /> <br />Matrix sW (Surrace Wafer) GW (Ground Water) • WW (Waste water)' OW (Drinbnp Water)' SL (Shdpa) • SO (3d9' OL (00.Other (Spe*) <br />AO -AMT 09)VAJ-RE FAR A, 49A1&X"V17Y 7?. <br />ASS ed) 64 >?? t obi 1 MNJ A, At , ZN, SuIFATF ?trA me k <br />Ni <br />N4? ?? > ?" (fl,??c.V? - <br />) <br />Please refer to AM terms & conditions located on the rave side of this COC. <br />PJ-1-11,10UISHFID BY a <br />3 e Idt?3 ?- ? K: <br /> <br /> <br />FRMA0060.03.05.02 White - Retum with sample. Yellow - Retain for your records. <br />I <br />L61809: Page 21 of 21 I