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L/-?993? <br />JACZ Laboratories, Inc. <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334-5493 <br /> <br />Name: <? r v ne v )C r v+ Address: $ v S o R <br />Company: v a 1?? ?1 Coy- V•e. Z. co 16 t?? <br />E-mail: K Ktv» P- Ot. ux„ VS Telephone: C, -7D • to S " Oa ? <br />Copy of Report Name: <.Q 1-41^ t-=: vKv? ? t E-mail: 14 e_ b O S a O j. C OW <br />Compan ., V"A- S V? R ?t t 1 S 1M 1 V? 111 C o Tele hone: SS ty 3 • 71 1 23 $ to 7 6 - ? <br />invoice to: <br />Name: {y t 4 - rvt me 4 f <br />Address: <br />Company: PIt S kV >CilCe 1 IS YVI t v1 r Yt CU <br />E-mail: ao/. Cow) Telephone: ?3{v3r ac(1. 23%3 ar 5361- tv7(n• 333.a <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 proceed with the requested analyses, even if HT Is expired, and data will be qualified. <br />Are samples for CO DW Compliance Monitoring? YES <br />If yes, please Include state forms. Results will be reported t o PQL. NO <br />PROJECT INFORMATION ANAL YSES R EQUES TED (attach list or us e quote number) <br />Quote #: ` 0 •- SPLL 3 -?>DS-0 <br /> <br />Project/PO #: 1n <br />Reporting state for compliance testing: <br />Sampler's Name: C t; r ww v, K t vt C fJ <br />Are any samples NRC licensable material? Yes <br />s • a' <br /> <br />H- ° QL <br /> <br />Rr-ss -oo? -i? fa09 ?? to og <br />//,'.-50 s c?, <br />i?r-ss-oo.3.?,s?ao? ?1?ro1oS ??o? sib ( <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br />Matrix SW (Surface Water) • GW (Ground Water) • WW (Waste Water) • DW <br />i. <br />kyj (Drinking Water) • SL (Sludge) • SO (Soil) • OL (Oil) • Other (Specify) <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC. <br />RELINQUISHED DATE:TIME RECEIVED BY: DAT <br />2 k_=?? - <br />? <br /> <br />FRMAD050.01.15.09 White - Return with sample. Yellow - Retain for your records. <br />Page 39 of 39