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ACZ <br />2773 Downhill <br />Name: <br />Laboratories, Inc. <br />Clove Steamboat . CO 80487 (800) 334.5493 <br />G e 7y- SO <br />Address: /IS ,41V VST <br />Company: j NtR FUELS <br />FiUQ / CD Q 2 26 <br />E -mail: <br />Telephone: 7 /qt 78V 639S <br />Name: SA M E <br />E -mail: <br />Company: <br />Telephone: <br />Name: SAM <br />Address: <br />Company: <br />E - mail: <br />Telephone: <br />if sample(s) received past holding time (HT), or if insufficien HT remains to complete YES <br />analysis before expiration, shall ACZ proceed with requested short HT analyses NC) <br />I I'l/11 ten At l A O f UAlrl rlwyrn fi tat irw ta. A]..A.. r n. Pt) <br />IMAf alut ACI AJI ;Amami wept tlYMA/A.11 Ml V..• • 11 A A ne.frteu ] MIA A.II 0.' 1UM4.1 <br />H <br />Are samples for SDWA Compliance Monitoring? <br />If yes. please include state forms. Results will be reported to PQL for <br />Yes I I No L J <br />Colorado. <br />Samplers Name Samplers site Information <br />State <br />Zip code <br />Time Zone <br />Quote # <br />m <br />0 <br />�f <br />ProjectfPO N: 5 UT f-I F I E L.1) <br />Reporting state for compliance testing: <br />Check box If samples Include NRC gowned <br />MW -93 <br />malerlat7 <br />(S —I3 -/? 614.0 <br />61.v <br />/41,4/ -/S <br />6•/3•/1//;s'9 <br />6-14) <br />V <br />Matrix SW (Surface Water) OW (Ground Water) • WW (Wales Water) • OW (Drinking Water) • St. (Sludge) • SO (Sot) • Of. (Of) - Other (Speedy) <br />E - -4- It - GA/ . , <br />Please refer to ACTs <br />..� <br />tams 8 conditions located <br />.fie <br />on the reverse side of this COC <br />FRMADO5O.02.11.11 <br />White - Return with sample Yellow - Retain for your records. <br />