2013-09-12_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 9/12/2013
• Doc Name: Surface Water Data for July 2013- 2.
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: TAK
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal
C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Caiion City, CO 81215 Nucla, CO 81424
Sample Loc. /ID No. _� tif/ �� Lab. NO.(S)
J
Sample Date 7__ - ?'' 3Time
Collected By
Field Custodian) 't
Delivered By
Received By
Date Recd.
Time Recd.
1. Sample Type: Air Water
2. Analysis — Test series requested: 4
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
... • of
Soil
Other (specify):
3. Field Data — Preservation:
7 CC
4,
6
s 4. Date analysis required by (if not Holding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial
COMMENTS — Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES
QAC
) and explain below.
) NO( ) If NO, explain:
Date
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