Laserfiche WebLink
COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />' <br />Sample Submittal : ' -.-� s 2? 099 _ <br />C: P.O. Box 1750 <br />Canon City, CO181215 2) P <br />Sample Loc. /ID No. --> L <br />S: P.O. Box 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Nucla, CO 81424 <br />Sample Date r - �-•3 ` 13) Time IS : 5 0 <br />Collected By 0(1 i �nk"'- <br />Field Custodian O b P' )� t <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />VVLbCL <br />VLl'Ol1.0 <br />�L^-CSNli7lilVR <br />LIZ <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />L{a- boratory Destination if not Cotter: <br />234 `;: f(.-cc t )I L. .11 r <br />(/ 4,,t2ce--- b,,JK 18 2.601 <br />�c. • f 'P.-o" 1. Sample Type: Air Water ' Soil _ <br />2. Analysis - Test series requested: C oak- 1 <br />3. <br />4. <br />5. <br />Other (specify): <br />Fie d Data - Preservation: <br />rtxld 2Z 0(, <br />Date analysis required by (if not Holding Time): _ <br />Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial <br />COMMENTS - Explanation of noted items: <br />) and explain below. <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO( ) If NO, explain: <br />QAC <br />Date <br />i <br />— - — - - - Page 8 of 8 <br />