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t��'pT <br />ay <br />7 <br />Era <br />UZ Laboratories, Inc.�;�� <br />2773 Downhill Drive Steamboat Springs. CO 80487 (800) 334 -54 <br />Name: Lewicki & Associates <br />Address: 11541 Warrington Ct <br />Corn an: Greg Levi ink i <br />Paykpr- CO 80119 <br />E -mail: <br />Telephone: (303)346-5196 <br />Name: John R. Trujillo <br />E -mail: 'rt @tru ' illodevelo went. co <br />any; <br />Tele one: — <br />Name; <br />Address: <br />Company: <br />Parker, CO 80138 <br />E -mail: <br />Telephone: <br />If sample(s) received past holding time (HT), or if insufficient HT remains to complete YES X <br />analysis before expiration. shall ACZ proceed with requested short HT analyses? NO <br />If-NO' then ACZ will tOntaCt Client Inr rtltther Instructean II r**ther •YES- net 1,10" <br />Fs Irtdicated. ACZ volt pOCeed wlm the requested 9nelysm even If Hl Is eapinxl, and data will be quellfled. <br />rAre samples for SDWA Compl lance Monitoring? <br />Yes No LLJ <br />If yes, please Include state forms. Results will be reported to PQL for Colorado, <br />ISampler's Name. Sampler's site Information <br />State <br />ZA&A21 <br />1 TlrKtorne <br />Gluote #: MINE — WATER <br />Project/P0 #: <br />o� <br />Reporting state for compliance testing: <br />0 <br />0 <br />U <br />Check box if samples Include NRC licensed material? <br />o <br />at: <br />UG -1 01 16 12 10 <br />6 <br />Y411 <br />R <br />se <br />is ar <br />e <br />UG -2 <br />R <br />dr'ft <br />above <br />i <br />ter <br />ec <br />IIG -3 <br />Alas <br />Drift <br />146 <br />r <br />SW -3 <br />RV <br />Lak <br />seep <br />w <br />J-71-1 <br />Matrix SW (Surface Water) GW (Ground Water) - WW (Waste Water) • DW (Drinking Water) • SL (Sludge) • SO (Soil) • OL (Oil) • Other (Specify) <br />2 coolers with 48 bottles <br />Please refer to ACTS terms & conditions located on the reverse side of this COC. <br />4— <br />ILL <br />w <br />Lon <br />Vow. <br />