Laserfiche WebLink
11GZ Laboratories, Inc. <br />2773 Downhill Drive Steamboat Sprin.s, CO 80487 (800) 334 <br />Name: S &cc. ark. <br />5493 <br />HT remains <br />short <br />ualared <br />1 <br />\5 <br />Address: 44 unk t S u \k 30C1 <br />Company: GovAer AsSOGla*-S <br />LQ-ke.�ohck. CO t223 <br />E-mail: , ttp..... Irtowle. v1.5 @ ", -kae.r. ( ON <br />Telephone: 303- qAo — Osy 0 <br />Name: <br />E -mail: <br />Company: <br />Telephone: <br />Name: cc,, t�Ci,Y tvk5 <br />Address: y4 (AlnioA 13t0 $atte 300 <br />Company: Gov7iP!f Assezat <br />Lakeuscoct co niZ$ <br />E -mail: Sew°,— kc..-ktt tie .00tv't <br />Telephone: 3O -09(Q <br />If sample(s) received past holding time T). or if insufficient <br />analysis before expiration, shall ACZ proceed with requested <br />a'NO' then ACZ well contact client rot further Instruction If neither 'YES" nor - NO <br />1s mOKaled. ACZ will proceed war the requested analyses, even If HT is expired and data <br />to complete YES <br />HT analyses? NO <br />Are samples for SDWA Compliance Monitoring? Yes L 1 No L — J <br />If yes. please include state forms Results will be repor PQI_ for Colorado <br />Sampler's Name: Sampler's site Information <br />State <br />Lr e) * 0770 t 1 <br />Zip code <br />Time Zone <br />Quote #: Noc..c► OA Gw <br />` Iti <br />U <br />o <br />L I <br />Project/PO #: 103 - $1‘L({ ( <br />Reporting stale for compliance testing: C. (, <br />Check box if samples include NRC licensed material? <br />P W-01011311% . 8 J311 It 1024 <br />6 W <br />rrnwr- 62,0t3t 11 0430 1124 <br />Gw <br />9 <br />X <br />ww- 63043111 , eiai 11 t31d <br />Gui <br />4 <br />X <br />OW -20 0$311 t 6S /31 II I335 <br />61J <br />`1 <br />X <br />LMtki -1513631 It 65 3 19410 <br />Cite <br />9 <br />X <br />1M14-04 tit3111 , 21131 II 151h <br />Cw <br />Matrix SW (Surface Water) • GW (Ground Water) - WW (Waste Water) - DW (Drink Water) • SL (Sludge) SO (Soil • OL (OM) - Other (Specify) <br />Please refer to ACZ's terms & conditions located on the reverse side of this COC. <br />(4 63M11111 Mita IIIIIr <br />- �ilr , <br />FRMAD050.02.11.11 <br />White - Return with sample. Yellow - RetainQor your records. <br />Page 35 of 35 <br />