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N <br />A Laboratories, Inc. ?... ? • . <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800 334 3 <br />Name: COLL( - Address: PO. 5 11 <br />Com an , W%Nr ROYALS 1(EAN'Ti'.. ES LLd DULL --2-*- <br />E-mail: 'n4 b 'nes ' . Telephone: 420 -.5166- <br />Copy Report <br />Name: 60RDON 45• 1At99vE-mail: a 7d o <br />Com an : 1,16V VAr xeoy13L;>E Tele hone: -40 2-7 5 - 25441 <br />Address: <br />Name: <br /> <br />1?7(d,?£S <br />MDa' C' Y9L <br />Company: <br />E-mail: Tele hone: <br />if sample(s) received past holding time (HT), or If Insufficient Kr 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 />Is indicated, ACZ wilt roceed with the re ted anal seven if fff is a red and data will be cLuallfied. <br />PROJECT OINFORMATION ANALYSCS REQUESTED (attach list or use quc)temmurnber) <br /> <br />OR - <br />Quote C! A MOM/ <br />Pro•ect/PO #: <br /> <br />? <br />Reporting state for compliance testin : Co <br />8 <br />Sam ler's Name: <br />le s NRClicensable material? <br />Arean <br />sa <br />g <br />o <br />a <br />. <br />GW 3 <br />2- y-f2-off u-40 <br />D040e 12- 2 --a- f1=30 6W 3 <br />001105 4 2•- 3 h:20 6W 3 <br />%2.- W4 -t, - WOO 6W 3 <br />iz- HA -,<-- M 6 -s 3 <br />00+09 iz - ivy Gw 3 <br />0 .x,09 i2 -- i- Is W <br />00 12- POND -r? - 10:3 sw 3 <br />004011?--- MW J ..j' <br />00-091'2 - C. W Mlt-- 12:5o G <br />Matrix SW (Surface Water) • GW (Ground Water) • WW (Waste Water) • DW (Drinking Water) - SL (Sludge) • SO (Soil) • OL (Oil) • Other <br />DISCLOSURES <br />REMARKS/ SAMPLE Please noit 004012-Cw sd` oir ho1'o, <br />but Zt iS SV11 Gfn? ?,red row Q21?oa W/ r10' OCW' 'A i e4 . PAGE <br />• /'?ff d?iaat ?b AtC shut Ar a- -&j/ .sit cf ? sr ?° <br />of <br />Sa??lPd '??" '7?r art- /"el?crt•?ac? . <br />Please r fer to ACZ's terms & ondttlons located on the reverse side of this COC. <br />RELINQUISHED BY: DATEi I-IML RECEIVED BY: DATE:TIME <br /> <br />Z ?o?- • a <br /> <br />FRMAD050.03.05.02 White - Return with sample. Yellow - Retain for your records. L65014: Page 26 of 27