Laserfiche WebLink
. 1 <br /> COTTER CORPORATI0A4§AMPLE SUBMITTAL AND TRACKING FORM <br /> Sample Submittal "`_' S 274" <br /> C: P.O.Box 1750 S: P.O.Box 1750 N: P.O. Box 700 <br /> Cation City, CO 81215 Cason City, CO 81215 Nucla, CO 81424 <br /> Sample LocAD No. .jj� tqf Lab. No.(s) <br /> Sample Date ` '�' Time Jf. Y 5 Date Data Entered <br /> Collected By iS�. ':>,jam 1 ; Data Entry By <br /> Field Custodian '< P/.•t/.L-+ Laboratory Destination if not Cotter: <br /> Cotter Off-Site Destination <br /> Delivered By /' k 7 <br /> Received BY 1 -� .ff r f rr{ 44- <br /> L—, <br /> d — <br /> Date Reed. <br /> Time Reed. R 05 <br /> 1. Sample Type: Air Water Soil Other (specify): <br /> 2. Analysis- Test series requested: <br /> 3. Field Data -Preservation: r Z .r/� �, J �)' .. f/ `K1 <br /> /1'1 c i' f" � � .� �i � • !. ..� f i.,•. � `J �.1�� i-J F�rV.. J-. {i .a t c � ' <br /> 4. Date analysis required by (if not Holding Time): <br /> 5. Special handling conditions or other instructions: <br /> 6. Invalidating circumstances? If YES initial ( ) and explain below. <br /> COMMENTS-Explanation of noted items: <br /> ( ) Check if additional attachments. <br /> QA Review: <br /> Sample valid? YES ( ) NO ( ) If NO,explain: <br /> QAC Date <br /> Page 19 of 20 <br />