Laserfiche WebLink
/q13Z Laboratories, Inc. . 0 <br />2773 Downhill Drive Steamboat S rin s, CO 80487 800 334-5493 <br />Name: LII'Vk 69LWV1 Address: ?Q <br /> <br /> <br />Y CO <br />Comp an : <br />t4au <br />E-mail: + M04 Telephone: <br />5 <br />.• • Report <br />Name.: GV £, 5?A1 E-mail: @ Q? ir„; Go <br />L <br />Tel e hone: Zp - v'?S 3y?/8 <br />n : tia <br />Invoice • <br />Name: Address: <br /> <br />iPO <br />Company: ffazaf <br />E-mail: Telephone: <br />If 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 />is indicated ACZ will roceed with the re guested anahjw, even if HT Is ex ired and data will be ualified. <br />PROJECT INFORMATION qua4e number) <br />Quote #: D /? 12A <br />Protect/PO #: c <br />Reporting state for compliance testin : <br />0 <br />Sampler's Name: <br />Are an samples NRC licensable material? 0 <br />• • R• <br /> <br />)t r - t- 9 Z; ?w <br />QQ4- <br />W <br />pa:::? o Gi.? <br />00 - wi 11-1q -d+ 13s 30 6 w <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Matrix SW (Surface Water) • GW (Ground Water) • WW (Waste Water) • DW (Drinking Water) SL (Sludge) SO (Soil) • OL (Oil) Other <br />REMARKS/ SAMPLE DISCLOSURES <br /> <br />v -fir/ set ?' ?•zaA ? ,Ge <br />-hm adv -)6 yg* <br />1)? A • PAGE <br />NO'k : CA( SG POP W 4/14 t4n / ? /treet of <br />Please refer to ACZ`s terms & conditions located on the reverse side of this COC. <br />RELINQUISHED D• DATE:TIME <br /> <br /> <br /> <br />FRMAD050.03.05.02 White - Return with sample. Yellow - Retain for your records. L66384: PaEe 15 of 16