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Laboratories, Inc. (:1 IAN i ,` ( 'i i )i } <br />( <br />110 <br />2773 D•wnhiil Drive Steamboat Springs, CO 80487 (800) 334-5493 <br />Name: 1_uf t, ' it �� Address: /6 ;0'7 • e. . r._ oQ <br />Company: : [ i + - - /. - t <br />Telephone: Vo3 . 2.31. °f I I r <br />Name: �. -�c.k ottoAck.K. , t. � . _ /1 �, • <br />Com. -ny: t_„ Telephone: 7/0- <br />I _ •_ Address: . t' , .• :. 0 ,0 <br />Company: <br />A ele• one: • <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 �a <br />r -NO' then ACZ will contact client rot bother instruction. d neither 'YES' nor 'NO' is indicated. ACZ will proceed web the requested efttiersAr Late <br />natyses, even J HT is expired, and data will be qualified. <br />Are samples for SDWA Compliance Monitoring? Yes ■ No MI <br />If es. a lease include state forms. Results will be reported to PQL for Colorado. <br />•.� <br />Sampler's Name: t...14- .•.• ...... Sampler's site Information State CO Zip code - Time Zone n 1 <br />Quote #: N ~ • <br />C O <br />Project/PO #: E' 0 it r r 2,01 . &b.. 1 Fi "•• f,-, N <br />C t a ,' <br />Reporting state for compliance testing: , o <br />• <br />Are any samples NRC licensable material? Yes / ( o 9 <br />Mw- 3 -30-1 t, Gw 3 X ■■� ■� ■r <br />1111M3 3 - 3 0- ( l --- In K ■ ■■ ■■ ■r <br />Ii 1o0 - Z ®i 0 Z 2 X ■�■� ■■ <br />, I-- 3 -'►' ®U! 2 - x ■�■■■r <br />MI <br />MI MI MI Ing <br />=Mil <br />Matrix Matrix SW (Surface Water) • GW (Ground Water) • WW (Waste Water) • DW (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 />! i . <br />Imo!APIA <br />1 <br />FRMAD050.02.17.10 <br />White - Return with sample. Yellow - Retain for your r s. <br />Page 13 of 14 <br />