2012-06-12_HYDROLOGY - M1977348

• Permit No: M1977348
• IBM Index Class Name: HYDROLOGY
• Doc Date: 6/12/2012
• Doc Name: FIRST QUARTER 2012 GROUNDWATER SAMPLING
• From: GOLDER ACCOSIATES
• To: DRMS
• Email Name: ECS
• Media Type: D
• Archive: No

ACZ Laboratories, Inc.0
2773 Downhill Drive Steamboat Springs, CO 80487 [phone]
Name: Sara VAcpa. k \ A-s
HT remains
short
qualthed
Address: 94
Upubv. 61 u4 Ste . 30
Company: es1Qe:NC
_
kV . .t♦ ' 0 ; O Z ;
E -mail: ., _ Inew _ A. ? ; . , u
Telephone: 34 3- ` , d - OS �{ a
Name: (A . i •
A.
E-mail: % piaci,
Kt . ( g,I ert. (,tour, _
0 — - ; • • 1 40
Compan : 67016
Telephone:
Name: Eck R (1'r 4.*
Address: t'{ y Wi i t34 t*d Skk • 30 0
company: Gelder AS5oci�
tqk ., A Gc- �Ou$
E -mail: EA-1700 044 e get itte r' . CO M
_
Telephone: 30 ISO —054 0
If sample(s) received past holding time (HT), or if insufficient
analysis before expiration. shall ACZ proceed with requested
If NO than ACZ will contact chant for further instruction If neaner'YES' nor 'NO'
I s Indicated ACZ wIll proceed with the requested analyses even d HT is expired. and data will be
to complete YES
HT analyses? NO
X
Are samples for SDWA Compliance Monitoring? Yes L—� No
Les, please include state forms Results will be reported to PQL for Colorado.
I
Sampler's Name 31,
Sampler's site Information
State
o
U
o
ii
GO
••
X
Zip code
Time Zone
Nit
Quote #
Project/PO #:
Reporting state for compliance testin
Check box if samples include NRC l icensed
VIA 11 - 1
meterial�
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6111+V- 24
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Matrix SW (Surface Water) GW (Ground Water) • WW (Waste Water)
yotile o -c \er It. zO 23-ZS
Please refer to ACZrs terms & conditions
• DW (Drinking Water) • SL (Sludge) • SO (Soil) • OL (Oil) • Other (Specify)
Z.
located on the reverse side of this COC.
MIR= AM
Ilr
/fills MIFAI Wiri,
1
1
FRMAD050.02.11.11
White - Return with sample. Yellow - Rdfain for your records.
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