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10Z Laboratories, Inc. <br />Downhill Drina SnearMM Sp wxj& CO 80487 (800) 334 -5453 <br />Lensample(s) received past holding time (HT). or if insufficient HT remains to complete YES <br />s before expiration. shall ACZ proceed with requested short HT analyses? NO <br />AUwACOMM-1e.lan.ther.rstn,u�m tlr�anfw •.'ES'�+n. •tea• <br />ples for SDWA Compliance Monitoring? Yes No ease incl state forms. Results will be reported to PQL for Colorado. <br />r�.yu• xr 1 SamDWs site Information State 01 j 1 Zip code Time zone <br />U) <br />d <br />Wo V. @ <br />WK! stale for Contpllanoe wdft: c0i <br />boot 9 samples kwkide bRC kwood malefiel? o <br />aim <br />Minix sw (SM16M Ws W • GW (Grand WMer) • WW ( wafer) • DW (O bftV VMK) • SL WAJdpe) • so (Soi) • oL (off • 011W (Sps*) <br />M_ <br />I Please rdw 1b AWS lerfrta & Ooriddlom IOC W on Ow rGV6B6 Sid6 Of t B COC. <br />FRMAD050.02.11.11 Whft - Rednn with sample. Yellow - Retain for your records. <br />IN <br />r3 <br />Page 9 of 9 <br />