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Report to: <br />CHAIN of CUSTODY <br />• <br />ACZ Laboratories, Inc. <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 33� I <br />Name: (_+oR. / Lou t-t QC 5 <br />Company: ti#kltjtrLS0t.3 't'\1%4 , (as5►,)LTl 5 <br />E -mail: COY attske.he Sc�1Wl��A \Y� Co *NA <br />Copy of Report to: <br />Name: <br />E -mail: <br />Quote #: G VV <br />37E LA r►rk-NNA <br />Company: ML�1 M VS <br />Invoice to: <br />Name: CoiLMt_E W41D . ANALYSIS <br />Company: t tm cOtJ Kum(' CONSULT+ s <br />C,Of) U"1A. nQSOWIAti Mt1 COM Telephone: 303 — <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 requested anal ses, even if HT is ex•ired, and data will be qualified. <br />ROJECT INFORMATION <br />ANALYSES REQUESTED (attach list or use quote number) <br />Project /PO #: ALDA LE Cam` / PSU M <br />Reporting state for compliance testing: <br />Sampler's Name: e.OR Y L-, * I1>it; <br />Are an sam les NRC licensable material? Nb <br />SAMPLE IDENTIFICATION DATE:TIME Matrix <br />PAT 01 <br />LAS Ot <br />Ha L 'i <br />LfTOL <br />MAKGI <br />CO RY Lovi.'oES <br />FRMAD050.03.05.02 <br />31 11 <br />2003 11! .5 <br />wC, 12:00 <br />1 17 2IkS iz :Lb <br />alum I.2.' <br />3117)2(X 't 13 : 00 <br />31 JZ12oo$ l 3: 15 <br />3zjwo� 13:3o <br />3Jt'1 Zoo 1 3; 40 <br />3 I 11 I2ca 13. <br />3117J2003 <br />Gw <br />GW <br />GW <br />GW 11O <br />Gvsl <br />GW <br />Gw <br />GW <br />GW <br />3111(08 i"t : <br />Address: 2801 `IOt)t. & I ELD S. So1T6 111 <br />Telephone: ,03 - ySG - 5 <br />E -mail: ScE Lf VIR -NIJA ( [M. IA <br />Telephone: 719- 704 - [ 2.D9 <br />Address: ZgO Yout & l eLb ST. Sth Er rt 1 <br />0 <br />1, <br />co <br />L <br />0 <br />U <br />0 <br />cD <br />G F. , CA 34 01 <br />C&oCD aDOf (-0 o1 - D <br />REMARKS/ SAMPLE DISCLOSURES <br />Matrix SW (Surface Water) • GW (Ground Water) WW (Waste Water) • DW (Drinking Water) • SL (Sludge) • SO (Soil) • OL (Oil) • <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC. <br />Other <br />PAGE <br />of <br />2. <br />RELINQUISHED BY: <br />DATE:TIME <br />RECEIVED BY: DATE:TIME <br />White - Return with sample. Yellow - Retain for your records. <br />3/848 / /•O <br />L68214: Page 47 of 51 <br />