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Report to: <br />CHAIN of CUSTODY <br />ACZ Laboratories, Inc. L -1 <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334 -549 <br />Name: CORY LoOKi be <br />Company: I' CFI' Nti:iNe Cwsu 1.10,1 f.s <br />E -mail: Cor Q Y1441eSoY1Kl rLt • ,Go <br />Copy of Report to: <br />Name: <br />Company: i4.p L.c./ r/( U 5 <br />Invoice to: <br />Name: CoALDALC 4,JATIG►e, i LJYf(,j51 S <br />Company: I IA7 a/ 14iNiA & �'aftfSL[/ Ti4/J DL4 A/ t f 0 <br />E -mail: Cort.(Q IMU;H1Q$0/4/1JiihN - C.f>M Telephone: 303-415 r ( 3 R <br />If sample(s) received past holding time (H1 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 uested anal ses, even if HT is expired, and data will be •ualified. <br />PROJECT INFORMATION <br />• <br />ANALYSES REQUESTED (attach list or use quote number) <br />Quote #: GW <br />Project /PO #:COALDA -L.€ 6 yPSurrl <br />Reporting state for compliance testing: <br />Sampler's Name: CO2y LOO k IDES <br />Are an sam <br />SAMPLE IDENTIFICATION DATE:TIME <br />Matrix <br />Btu (zit <br />MYE mi <br />REMARKS/ SAMPLE DISCLOSURES <br />Matrix SW (Surface Water) <br />RELINQUISHED BY: DATE:TIME RECEIVED BY: <br />• <br />DATE:TIME <br />O <br />>7 <br />Co 9 L00 kt0E5 <br />FRMADO50.03.05.02 <br />Lftn PrNMIA <br />Acz (D : L.682-1 <br />les NRC licensable material? /1 <br />Al 17 <br />2.00A 1a 3D <br />'4lt i(ot /roc. <br />White - Return with sample. <br />GW <br />Address: 28o 1 YovNGI 4 D S �, Svrr 11 l <br />Got D IJ, Co �Co4D t <br />Telephone: 303 - LI 5 ,j o 3T3 <br />E -mail: Toe.. LFM Q t- )0[4../ M ,G0r`'1 <br />Telephone: ' 1 1 9 - 7 / - 1 2_D ( <br />Address: 7401 YovNGFIfoi) sT £'vi - E 17 1 <br />GW <br />$00 <br />round Water) • WW (Waste Water) - OW (Drinking Water) • SL (Sludge) • SO (Soil) - OL (Oil) Other <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC. <br />Yellow - Retain for your recordsPage 13 of 16 <br />PAGE <br />of <br />