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0 <br />�s <br />t? <br />Mr. <br />aw <br />asim <br />AUZ Laboratories, Inc. <br />1' <br />2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334 - <br />Name: Address: jt„ 'Q /, f3iad. <br />Company: j <br />E -mail: Telephone: 30 S� <br />m m © E -mail: o k o �0. <br />Company: r Telephone: D - — p <br />Name: Address: Licl ajacr <br />Company: -z L 8 <br />E -mail; jov,.< t X i^^ Telephone: .303 <br />If sample(s) received past holding time (HT), or if Insufficient HT remains to complete YES <br />analysis before expiration, shall ACZ proceed with requested short HT analyses? NO <br />r'NO' then ACZ m0 COMO clierN for further inslruCtion If nONher "YES' nor WY <br />s inkcated, ACZ will proceed with the requested analyses even if HT is expired and data will qe gUalified <br />Are samples for SDWA Compliance Monitoring? Yes No X <br />If yes. please include state forms. Results will be reported to PQL for Colorado. <br />ampler's Name: AA S Sampler's site Information State <br />CP <br />Zip code <br />Time Zone <br />!ti► <br />Quote #. tA6 I c e e <br />lc <br />Project/PO #: b t V 3 <br />Reporting state for compliance testing: <br />o <br />Check box if samples include NRC licensed material? <br />a <br />f <br />I W <br />3 <br />-3 <br />zz /,):Do <br />3W <br />>G <br />, <br />W <br />3hqluo <br />61f <br />-3I11 ZA1 <br />3 <br />ocl <br />3J J3 ;S <br />W <br />Matrix SW (surface water) GW (Ground water) - WW (waste water) • OW (Drinking water) • SL (sludge) • So (soil) • OL (Oil) • other (Specify) <br />-- (Y1e, S "ki e. TV:, n <br />Please refer to ACTs terms & conditions located on the reverse side of this COC. <br />FRMA0050.02.11, ll White - Return with sample. Yellow - Retain for your records <br />a <br />Page 26 of 26 <br />