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Home My WebLink AboutConditions of ApprovalETANOARD BACTERIOLOGICAL WÀTER TEST sNow'rlÀss wAfER À SÁHÍTATION DlsTRlcl P.O. BOX 5700 - SilOWMAsS VrLlåGE, CO 81615 PWSIO{-.-- SBmpto SAIIPLE TAKÊN; t*þ.,Htrtûútb\ Le f.jry-Il- o^¡eNJúþ-r,,uel&@NAruËoFsuppryE--{,¿L.t¿f,¿l..*.-.* couru¿ÈfiéJÀnumrn ï.rlr*t,h$HronrNe REsrouÂL .-_-- - ..-. MGIL ) ROUTINE DISTRIBUTION SYSTEM SUPPLY ) CHECK SAÀ¿PLE { ) PFOCSSS WÀTER)RAW trfcRouNt} { }suRFA6E ) SPÊCIAL PURPOSË SAMPLE AHÀLYST'SIART ÁNA!YST/rlMsH UNSUTTABL€ FOR IESI C] RESULTS B.hoü. lålt COLIFORM E.COLI COLIFORM E,COLI PRESENÏ PRESENT { ) COMMUNITY SUPPLY ( { ) NÖN COMMUNTTY ( f ) o'rlrÊR PUBLTC {( ) PRlvArE ( "NOTE; IFALL NFCfiMATION lS NOI SUPPLIEÐ, THË SAMPLE WLI BE OISCAÃDED. SgË REVERSE FOR ÏIME SAMPLING INSTRUCIIONS ANO DEFINITIQNS, REMARKS l*rril REÏURN ,AÐÐRESS MPN MPN ÐO NOT WRITÊ, N ÍHIS SPACE our-JgL+1,-7----:rnæ I I i t D- REc'rvËri *r, (ül¡ll.!-rrue lflÕ-f onresr RESULT8 GREAÍER THAN OI€ COLIFORM F€R tOO MI. INDICATSS NON{OMPI.I¡ANCE WTH MINIMUM OßINI(ING WATER BOTTI"E # AQUA TEC SYSTEMS, INC P.O. BOX 488 TLENWOOD SPRINCS, CO 81602 pH# (970) 984-031 I FX# (97ü) 984-Û312 AUGUST ?5, 2017 KARL ] HANLON P.O. DR.AWER 2û37 GLÊNTVOOD 5PR¡NGS, ËO 81602 kjh@mountainläwf¡rm"com TO WHOfVI TT MAY CONCËRN: WELL LOCATTON: PERMIT#48637 271 WILLOW LAI'¿E, CARBONDALE GARFIELD CO THE WELL WAS PUMPED CONTINUOUSLY FOR, THOURS AT 15 GAILONS PER MINUTE. THE TOTAL DRAW DCIWN OVER THË 4 HOURS OF PUMPING WAs 1,4 FEFT, THE WELL RËCOVERED TO WITI.ITN OF THE ORIGINAL STAÎIC LEVFL TI-I 3 MINL,TEs AFTER PUfvIPING WAS STOPPED, ÞATE OF TESTr OAÍ22t2ø17 APPROXIMATE STATIC I/I¡ATËR LËVELLåË. APPROXIIì,IATE DEPTH OF WELL¿:3åü. HORSE POWER OF PUMP: 3t*}!P APPROXIMATE PUMP SETTII-IGJ-¡2' TI.IE TEST DATA ÛBTATNED IS REFRESENTTTTVE OF ONLY CONDITIONS TBs€RVEÐ ON THAT DATE AND DOES NOT ACCOUNT FOR POSSIBLE SEASONALVARIATIONS :N THE AQUIFER NOR LONGER PUf"lpING DURATIONg' STATE LICENSE 1106 Patrick Waller From: Sent: To: Cc: Subject: Sheryl Bower Thursday, July 13, 2017 2:58 PM kjh@mountainlawfirm.com Pätrick waller Hanlon ADU Karl, I have reviewed the information you have provided from the Assessors and will accept this as evidence that there were two residential units in existence at the time the County accepted the Willow Lane North Extension. Regards, .sherul t. Eower,AlcPC) Garfield County Community Development Director LO8 8th Street, Suite 401 Glenwood Springs, CO 81601 (970',1945-L377 ¡I¡ITIttltIIITTIITITTIIII FlEScfUFICE ENGINEEFIING ¡NC Karl Hanlon, Esq Karp Neu Hanlon, P.C. P.O. Drawer 2030 Glenwood Springs, CO 81602 October 2,2017 RE: 271 Willow Lane - Water Quality Analysis for Existing Well Dear Karl: At your request, Resource Engineering lnc. (RESOURCE) analyzed the water quality for the existing well located at2Tl Willow Lane near Carbondale, Colorado. A water sample from the well was obtained on July 21, 2017 and submitted to ACZ Laboratories, lnc. (ACZ) for analysis. The results are summarized below. WATER QUALIW The sample was collected by Karl Hanlon and shipped by overnight delivery under proper chain of custody to ACZ (results attached). The ACZ Sample Receipt indicates that the samples were received within the recommended hold times and at the proper temperature. The green-ac container was not present and one was created using a portion of the raw sample. The sample was analyzed for the parameters required by the Garfield County Land Use Regulations. The results indicate that the wellwater meets the basic EPA primary and secondary drinking water standards. The wellwater is suitable for all potable water uses and outside irrigation. However, the well water did indicate a hardness of 350 mg/|, which is considered very hard. Hard water can cause scale to build up on water fixtures and lessen effectiveness of soaps. Although not required to meet water quality standards, RESOURCE recommends installing a water softener to lower the hardness of the water. Please call f you have any questions or need additional information Sincerely, RESOURCE ENGINEERING, INC. MichaelJ. Erion, P.E. Water Resources Engineer MJE/mje Attachments Con€ulû¡ng Engineens and Hydt'ologists 9Cl9 Colc¡nado Avenue E Glenwood Springe, CO B16Cl1 n t97jl945-8777 A Ëax [97Oì 945-1137 2773 Downhill Drive Steamàoal Sprlngs, CO 80487 (800) 334-5493 Report to: KarlHanlon KarlHanlon 271 Willow Ln Carbondale, CO 81623 AEilZ Laboratories, I nc. Billto: KarlHanlon KarlHanlon PO Box 3188 Glenwood Springs, CO 91602 August 18,2017 Project lD: ACZ Project lD: 138680 KarlHanlon: Enclosed are the analytical results for sample(s) submitted to ACZ Laboratories, lnc. (ACZ) on July ?5,2017 This project has been assigned to ACZ's project number, L38680. Please reference this number in allfuture inquiries. All analyses were performed according to ACZ's Quality Assurance Plan. The enclosed results relate only to the samples received under L38680. Each section of this report has been reviewed and approved by the appropriate Laboratory Supervisor, or a qualified substitute. Except as noted, the test results for the methods and parameters listed on ACZ's current NELAC certificate letter (#ACZ) meet all requirements of NELAC. This report shall be used or copied only in its entirety. ACZ is not responsible for the consequences arising from the use of a partial report. All samples and sub-samples associated with this project will be disposed of after September 17,2017. lf the samples are determined to be hazardous, additional charges apply for disposal (typically $11lsample). lf you would like the samples to be held longer than ACZ's stated policy or to be returned, please contact your Project Manager or Customer Service Representative for further details and associated costs. ACZ retains analytical raw data reports for ten years. lf you have any questions or other needs, please contact your Project Manager. Max Janicek has rêviewed and approved this report. Analytical Report 138680-1 708181701 Page 1 of 13 AEZ Laboratories, lnc. 2773 Downhill Drive Steamboaf Spnngs, CO 80487 (800) 334-5493 Karl Hanlon Project lD: Sample lD:WELL ACZ Sample lD: Date Sampled: Date Received: Sample Matrix: L38680-01 07/21/17 06:30 07/25/17 Ground Water lnorganic Analytical Results EPA l,lethodParameter Dilution Result Qual XQ Units IðDL PQL Date Analyst Total Recoverable D¡gestion Total Recoverable Digestion M200.2 tcP-Ms M200.2 lcP 08101117 '18:23 08104117 '17:18 enb dcm Metals Arsenic, total M200.8 ICP-MS recoverable Cadmium, total M200.8 ICP-MS recoverable Calcium, dissolved M200.7 ICP Copper, total M2oo.7 ICP recoverable lron, total recoverable M200.7 ICP Lead, total recoverable M200.8 ICP-MS Magnesium, dissolved M2oo.7 lcP Manganese, total M2oo.7 lcP recoverable Sodium, dissolved M200.7 ICP Uranium, total M200.8 ICP-MS recoverable Zinc, total recoverable M200.7 ICP mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L mg/L errb enb aeh aeh aeh enb aeh aeh aeh enb aeh0.01 0.05 08110117 16:48 U B 0.0002 0.0001 0.1 0.01 0.02 0.0001 o.2 0.005 0.001 0.0005 0.5 0.05 08102117 14:18 OBlO2l17 14:'16 08108117 17''28 08110117 16:48 0.0003 82.4 0.02 0.21 0.0011 14.1 0.008 4.0 0.002 B 0.05 0.0005 1 0.03 081'10117 '16148 08102117 14:'16 08108117 17:28 08110117 16148 o.2 0.0001 1 0.0005 08108117 17:28 081021'17 14:16 U EPA ldethod Dâte.Paramater Dilution Result Qual XQ Units filÐL PCL REPtN.02.06.05.0r 138680-1 708181701 * P/ease rcferto Qualifier Repofts for details. Page 2 of 13 AEilZ Laboratories, I nc. 2773 Downhill Drive Steamboaf Spr:ngs, CO 80487 (800) 334-5493 KarlHanlon Project lD: Sample lD:WELL ACZ Sample lD: Date Sampled: Date Received: Sample Matrix: L3868ù01 07/21/17 06:30 07/25/17 Ground Water Wet Chem¡stry Alkalinity as CaCO3 SM2320B - Titration Bicarbonate as CaCO3 Carbonate as CaCO3 Hydroxide as CaCO3 Total Alkalinity Chloride M300.0 - lon Chromatography Conductiv¡ty@25C sM251oB Conosivity (calc.) SM 2330 - caco3 Sl Fluoride M300.0 - lon Chromatogrephy Hardness as CaCO3 SM2340B - Calculãtion (dissolved) Lab Filtration (0.45um SoPwcoso filter) Lab Filtration (0.45um) M200.7/200.8/30054 & Acidification Nitrate/Nitrite as N M353.2 - H2SO4 preserved pH (lab) sM45ooH+ B pH pH measured at Residue, Filterable SM2540C (TDS) @180C Sodium Adsorption USGS - 11738-78 Ratio in Water Sulfate M300.0 - lon Chromatography mg/L 2 0.07 Arizona license number: þå:0102 1 1 1 1 2 1 2 176 176 3.41 501 0.9 0.14 264 20 20 20 5 10 0.1 0.'l 20 abd abd abd bsu abd calc bsu calc jnp sck pjb abd abd emk calc bsu 0.1 o.2 0.1 0.1 10 20 O7129117 O:OO abd U U 2 2 2 1 1 B mg/L mg/L mg/L mg/L umhos/cm Sl Unit mg/L mg/L 07129117 0:OO O7129117 O:OO O7129117 O:OO 08/08/17 16:06 O7l2Sl17 2i38 08/18/17 0:00 08/08/17 16:06 08/18/17 0:00 07129117 O:00 O7129117 0:00 08103117'15''23 0.5 5 B O7127117 13:OB 08/03/17 13:35 0.02 0.1 O8103117 22:49 8.1 23.4 324 0.11 't03 B H H mg/L units c mg/L mg/L2 08/18/17 0:00 5 08/08/17 16:06 REP1N.02.06.05.01 138680-1 708181701 * P/ease ¡efer to Qualiîier Reporfs for details. Page 3 of 13 AEZ Laboratories, lnc. 2773 Downhill Drive Steamboat co 804e7 taool 334-5493 Report Header Explanations Batch Found Um¡t Lower MÐL A distinct set of samples analfzed ât a specllîc tlme Value of the QC Typo of inter€st Upper limit for RPD, in %. Lower Recovery Limit, in % (except for LCSS, mg/Kg) Melhod Detection Limit. Same as Minimum Reporling Limit unless omitted or equal to the PQL (see comment #5). Allows for instrument and annualfluctuat¡ons. A number assigned to reagents/stândards to trace to the manufactureis cerlificate of analysis Practical Quant¡tation Limit. Synonymous with the EPA term "minimum level". True Value of the Control Sample or the amount ãdded to the Spike Recovered amount of the true value or sp¡ke added, in 0/o (except for LCSS, mg/Kg) Relative Percent Difference, calculation used for Duplicate QC Types Upper Recovery L¡mit, in o/o (except for LCSS, mg/Kg) Value of the Sample of interest PCN/SCN PQL QC Rec RPD Upper Sample QC Sanple Types ,4S ASD GCB ccv DUP tcB tcv ,csÁB LCSS LCSSD LCSW LCSWD LFB LFM LFMD LRB MS MSD PBS PBW PQV SDL AnaMicâl Spike (Post Digestion) Analytical Spike (Post Digestion) Duplicate ContinUing Calibration Blank Continuing Calibration Verificåtion standard Sample Duplicate lnitial Calibration Blank lnitial Calibration Verilicat¡on standard lnter-element Conection Standard - A plus B solutions Laboratory Conlrol Sample - Soil Laboratory Conlrol Sample - Soil Duplicate Laboratory Control Sample - Water Laboralory Control Sample - Water Duplicâle Laboratory Fortif¡ed Blank Laboratory Fortif¡ed Mâtrix Laboratory Fortif¡ed Malrix Duplicate Laboratory Reagent Blank Matrix Spike Matrix Sp¡ke Duplicate Prep Blánk - So¡l Prep Blank - Wáter Practical Quantitation Verifcat¡on standard Serial Dilution QC Sample Typå Explanations Blanks Control Samples Dupliætes Spikes/Fort¡fied Matrix Standard Verif¡es that there ¡s no or minimal contaminat¡on ¡n the prep method or calibration procedure' Verifies the accurâcy of the method, ¡ncluding lhe prep procedure. Verifes the precision of the instrument and/or method. Determines sample matrix interferences, if any. Verifies the validity of the calibrat¡on. ACZ Qualll¡ers (Qual) B H L U AnaMe concentration detected at a value between MDL and PQL. The associated value is an estimated quantity. Analysis exceeded method hold t¡me. pH is a lleld test with an immediale hold t¡me. Target analyte response was below the laboratory defned negative threshold. The material was anaþed for, but was not detecled above the level of the associated value. The associated value is eilher the sample quantitation limit or the sample detection limit' lYf¿tltod, Réþrencos (1) (2) (3) (4) (5) EPA 600/4-83-020. Methods for Chemical Analysis of Water and Wâstês, Mãrch 1983. EpA 6OO/R-93-100. Methods for the Determination of lnorganic Substances ¡n Environmentâl Samples, August 1993. EpA 6OO/R-94-1 1 1. Methods for the Determination of Metals in Environmental Samples - Supplement I, May 1994, EPA SW-846. Test Methods for Evalual¡ng Solid Wasle. Standard Methods for the Examination of Water and Wastewater. (1) (2) (3) (4) QC results calculated from raw data. Results may vâry slighlly if the rounded values are used in the calculations. Soil, Sludge, and Plant matrices for lnorganic analyses are reported on a dry weight basis. Animal matrices for lnorganic analyses are reported on an "as received" basis. An asterisk in the "XQ" column indicales there is an extended qualif¡er and/or certifcat¡on qualifier (5) lf the MDL equals the PQL or the MDL column is omitted, the PQL is the reporting limit. For a complete l¡st of ACZ'S Efended Qualmers, please click: http://www.acz.com/Oublic/extquallist.pdf REP001 .03.15.02 138680-1 708181701 Page 4 of 13 AEìZ| Laboratories, I nc. 2773Dawnhill Drlve SfeamôoafSpnhgs, CO 80487 (800) 334-5493 Karl Hanlon ACZ Project lD: L38680 lnorganic Extended Qualifier Report QUAL ÐËSCRIPTIONMETHODACZ IÐ I'VORKNUM PARAMETER L38680{¡l tA/G428515 Chloride RG608754 Conosiv¡ty(calc.) WG428515 Fluoride WG428495 Magnesium,dissolved WG428251 Nitrate/Nilrite as N M300.0 - lon Chromatography M300.0 - lon Chromatography SM 2330 - CaCO3 Sl M300.0 - lon Chromatogrephy M300.0 - lon Chromatogrephy M300.0 - lon Chromatography M200.7 tcP M353.2 - H2SO4 preserved DC Samplc rcquirod dilution. Non-target analytc cxcccdcd cal¡bral¡on range. RA Relative Percent Difference (RPD) was not used for data validation bêceuse lhe concentration of the duplicated sample is too lorv for accurate evaluation (< lox MDL). ZZ Laboratory measured pH and temperature were used in this calculation. Sampler did not report either field pH, field temperature, or both. DC Sample required dilution. Non-terget analyte exceeded calibration range. M1 Matrix spike rccovery was high, the recovery of the associated control sample (LCS or LFB) was ecceptable. RA Relative PèrcÆnt Difference (RPD) wes not used for data validation because the concentration of the duplicated sample is too low for accurate evaluat¡on (< 10x MDL). M3 The spike recovery value is unusable since the analyte concentration in the sample is disproportionate to the spike level. The recovery of the associated control sample (LCS or LFB) was acccptablc. RA Relat¡ve Percent Difference (RPD) was not used for data validation l¡ecause lhe concenIatiun of the duplicated sample is too loì/r, for accurate evaluation (< 10x MDL). HC lnitial analysis within holding time. Reanalysis was past holding time, which was required due to a QC failure during the initial analysis. WG428219 Residue, Filtereble (TDS) @180C SM2540C REP4D.15.06.05.01 138680-1 708181701 Page 5 of 13 AE|Z Laboratories, I nc. 2773 Downhill Drive Steamboaf Sprøgs, CO 80487 (800) 33+5493 Karl Hanlon Project lD: Sample lD: Locator: WELL ACZ Sample lD: Date Sampled: Date Received: Sample Matrix: L38680-01 07/21/17 6:30 07/25/17 Ground Water RadioGhem¡stry Analytical Results Gross Alpha & Beta, total M900.0 Prep Method ñls¿sure Bât?Ræult xePrep DatePavartebr LLD Units Gross Alpha Gross Beta 08117117 Ot18 08117117 O:18 2.8 3.4 2.6 2.5 4.4 12 pCi/L pCi/L ism ism Arizona license number: þ¿0102 h48680ìÐ11Ð8H 8í1701 Page 6 of 13 AE,Z Laboratories, tnc. 2773 Downhiil Drive Steamboat co 8u87 334-5493 Radiochemistry Reference Report Header Explanations Batch Eno4+¡-¡ Found Limit LCL LLÐ PCI\USCN PQt QC Rec RER RPD UCL Sample A distinct set of samples analyzed at a specific time Calculated sample specific uncertainty Value of the QC Type of interest Upper limit for RPD, in o/0. Lovt/er Control Limit, in o/o (except for LCSS, mg/Kg) Calculated sample specif¡c Lou/er L¡mit of Detection A number assigned to reagents/standards to trace to the manufacturer's certificate of analysis Practical Quantitation Limit True Value of the Control Sample or the amount added to the Spike Amount of the true value or spike added recovered, in o/o (except for LCSS, mg/Kg) Relative Error Ratio, calculation used for Dup. QC taking into account the error factor. Relative Percent Difference, calculation used for Duplicate QC Types Upper Control Limit, in % (except for LCSS, mg/Kg) Value of the Sample of interest QC Sample Types DUP ¿css LCSW Sãmple Duplicate Laboratory Control Sample - Soil Laboratory Control Sample - Water MS/MSD PBS PBW Matrlx splke/Matflx splke Dupllcätê Prep Blank - Soil Prep Blank - Water Blanks Control Samples Duplicates Matrix Spikes Verifies that there is no or minimal contamination in the prep method procedure. Verifies the accuracy of the method, including the prep procedure. Verifies the precision of the instrument and/or method. Determines sample matr¡x interferences, ¡f any. ACZ Qualifiers (Qual) H Analysis exceeded method hold time. Melhod Pretix Rêfèr€nce M SM D RP ESM EPA methodology, ¡ncluding those under SDWA, CWA, and RCRA Standard Methods for the Examination of Water and Wastewater. ASTM DOE DOE/ESM Gomments (1) (2) (3) (4) Solid matrices are reported on a dry weight basis. Preparation method: "Method" indicates preparation defined in analytical method. QC results calculated from raw data. Results may vary slightly if the rounded values are used in the calculations. An asterisk in the "XQ" column indicates there is an extended qualifier and/or certification qualifier associated with the result. For a complete list of ACZ's Extended Qual¡fiers, please click: http://www.acz.com/public/extquallist, odf REP003.09.12.01 138680-1 708181701 Page 7 of 13 AE|Z Laboratories, I nc. 2773 Downhill Drive Steamboat Springs, CO 80487 (800) 334-5493 Karl Hanlon ACZ Project lD: L38680 RadChem Extended Qualifier Report QUAL DESCR'PTIONMËTHOOACZ lÐ WOR¡(I{UM FARAII¡IETER No extended qualifiers associated with this analysis REPAD.15.06.05.01 138680-1 708181701 Page I of 13 AEilZ Laboratories, I nc. 2773 Downhill Drive SfeamåoafSpnngs, CQ 80467 (E00) 334-5499 KarlHanlon ACZ Project lD: L38680 Certification Qualifiers No certifcation qualifiers associated with this analysis REPAD.05.06.05.01 138680-1 708 181701 Page I of 13 AE|Z La boratories, I nc. 2773 Downhill Drive Steamboaf Spnngs, CO 80487 (800) 33+5493 KarlHanlon ACZ Project lD: 138680 Date Received: 0712512017 10:00 Received By: Date Printed: 712512017 Sample Receipt Receipt Verification YES NO NA X1) ls a foreign soil permit included for applicable samples? 2) ls the Chain of Custody form or other directive shipping papers present? 3) Does this project require special handling procedures such as CLP protocol? 4) Are any samples NRC licensable material? 5) lf samples are received past hold time, proceed with requested short hold time analyses? 6) ls the Chain of Custody form complete and accurate? The 'sampled by' field on the Chain of Custody rdas not completed. 7) Were any changes made to the Chain of Custody form prior to ACZ receiving the samples? X X X X X X 8) Are all containers intact and with no leaks? 9) Are all labels on containers and are they intact and legible? 10) Do the sample labels and Chain of Custody form match for Sample lD, Date, and Time? 11) For preserved bottle types, was the pH checked and within limits? 1 12) ls there sufficient sample volume to perform all requested work? 13) ls the custody seal intact on all containers? 14) Are samples that require zero headspace acceptable? 15) Are all sample containers appropriate for analytical requirements? L38680-01 : A green filt-ac container not received and a ne\^¡ container created from the rau, 16) ls there an Hg-1631 trip blank present? 17) ls there a VOA trip blank present? 18) Were all samples received within hold time? YES NO NA X X X X X X X X X X X The'Relinquished By' field on the COC was not completed. The prolect manager is contacting the client. Client Contaet Remarke Cooler Id Temp(oC)Temp Criteria ( oC) 3431- 3'3 <=6.0 15 Was ice present in the shipment container(s)? Yes - Wet ice was present in the shipment container(s) nad (pR,/Hr) Custody seal Intact ? Yes Page 10 of 13 REPAD LPII 2012-03 138680-1 708181701 AEilZ La boratories, I nc. 2773 Downhiil Drive Steamboaf Springs, CO 80487 (800) 334-5493 Karl Hanlon ACZ Project lD: 138680 Date Received: 0712512017 l0:00 Received By: Date Printed: 712512017 Client must contact an ACZ Project Manager if analysis should not proceed for samples received outside of their thermal preservation acceptance criteria. 1 The preservation of the following bottle types ¡s not checked at sample receipt: Orange (oil and grease), Purple (total cyanide), Pink (dissolved cyanide), Brown (arsenic speciation), Sterile (fecal coliform), EDTA (sulfite), HCI preserved vial (organics), Na2S2O3 preserved vial (organics), and HG-1631 (total/dissolved mercury by method 1631). Sample Receipt REPAD LPII 2OI2-03 138680-1 708181701 Page 11 of 13 Laboratories, lnc. Downhill Drive Steamboat Spnngs, CO 80487 (800) Address: L Name: Companv:tt E-mail I lr"leptrone: sample(s) received past holding time (HT), or if insufficient HT remains to complete before expiration, shall ACZ proceed w¡th requested short HT analyses? ACZ wlll for fufrhêr lnaùlct¡on. lf ACZ wlll evân ¡f HÎ ls"¡{o"w¡th lhe ând d¡t wlll bÊ qu.llnrd YES NO ler.sName:Sampler.sS¡telnformat¡onSfate-Zip 'l ¡llest to th. auth.ñtlcity and v¡lldlt}l of thls samplo. I unde6und thet ¡Dtên(onålly m¡3lebâl¡¡g tha t¡mo/dat€rlocation or bmpor¡ng wlth lhe s¡mplê ¡n snyHy, ¡s conaldorsd fraud ånd punlshâbl. by Stâtc Lsw. samples for SDWA Gompliance Monitoring? include stale forms. Results will be Time Zone o o .E .E Loo o rtÈ No #. PO#: pler's Signature: state for com include NRC licensed material?box if to PQL for Colorado Yes í!)f¿^t) l),-t.¡r'-z/a,l tt A lr¡t Kd r-t rzil,i in 6lt> RtLrnlnt r-LF.'.---íø !t', L'z¡l F:I'ùJ )l lo ! t Jz -/^:z^ 1/z/l '- 2:zx \A*' s..lL.re'. ù), Q'¡o/ itt-{*:o I /z-/ I iz ï-mat T -./ t SW (Surface Water) GW (Ground Water) .WW (Waste Water) DW (Drinking Water) . SL (Sludgê) . SO (Soil) . OL (Oil) .Other (Specify) CHAIN of CUSTODY Report to: Copy of Report to: -t lnvoice to ANALYSES REQUESTED (attach list ot use quote number)PROJECT INFORMATION SAMPLE IDENTIFICATION DATE:TIME Matrix RELINQUISHED BY DATE:TIME RECEIVED BY:DATE:TIME I To c Mâtr¡x Please refer to ACZ's terms & conditions located on the reverse side of this COC. fit LffilúåBeî?€t.fólfor White - Return with sample. Yellow - Retain for your records.Page 12 of 13 AF,Z Laboratories, Inó. 2773Downhill Drive Steamboat Spnhgs, CO 80487 (800) 334,6493 Account: HANLON/Kar| Hanlon Bottle Order: 8037975 Billto Account: Billto AGZ Ship Date Requested: 0711712017 Request Placed at: 0711712O17 A8:52 Service Requested: UPS Ground Sampling supplies 1 2 1 tl coc SEAL RETURN LABELS Chain of Custody Custody Seal Relurn Address Semple Labels Chain of Custody, 1 for 10 samples. Custody seals for cooler, two for each cooler Return Address lebel, one for eãch cooler. ACZ supplied labels for sample containers ACZ Coolers ':$i¡e, Wslght 't 3431 Large 10 r28101 300375151519 Quote number: Sample Quantity: WELL Residential Water Testing ACZ is respons¡ble for necessary sample filtering1 1 GREEN R.AW RED PC RED RAD WHITE YELLOW 125 ML 5OO ML 250 ML 1000 ML 250 ML 250 ML Filtered/Nitric Raw Red pre-cleaned Ra'/v/N¡tr¡c RaMNitric Filtered RadSulfuric Metals (d¡ssolved except ICPMS) - This is a filtered sample. Completely f¡ll container. Wet Chemistry (analyses that do not require preservative or filtration) - Completely fill container. Metals (total including ICPMS) - Do not overfill as there is Nitric Acid in the bottle. Radiochemistry (total) - Do not overfill as there is Nitric Acid ¡n the bottle. Wet chemistry (dissolved) - This is a flltered sample. Completely fill container. For total wet chemistry analyses. Do not overf¡ll ås lhere is Sulfuric Acid in ths bottle. Prepared By/Date: spl Page 1 of 2 Page'13 of 13138680-1 708181701