Laserfiche WebLink
COTTER CORPORATION SAMPLE SUBMITTAL Af%V"I KAq-Atngy r vuv, <br /> Sample Submittal Nas 2mli <br /> C: P.O. Box 1750 S: P.O.Box 1750 N: P.O. Box 700 <br /> Canon City, CO 81215.-- Canon City, CO 81215 Nucla, CO 81424 <br /> Sample Loc.f1D No. Lab.No.(s) <br /> Sample Date _5 <br /> 2 IV Time f f ''2 Date Data Eutemd <br /> Collected By _ x+, Data Entry By <br /> Field Custodian � Laboratory Destination if not Cotter: <br /> Cotter Off-Site Destination Energy Laboratories,lnc. <br /> Delivered By �'�'`� �' — 2393 Salt Creek Hwy <br /> Received By jL — Casper,WY 82601 <br /> ! fJ 1/ <br /> Date Recd. — - --- ----Time Recd. <br /> 1. Sample Type: Air Water Soil Other (specify): <br /> 2. Analysis- Test series-'iequew: <br /> 3. Field Data-Preservation: <br /> } r <br /> �� � •� � ti � ,ter•<, � _ � <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 20 of 20 <br />