2014-10-09_HYDROLOGY - M1977300 ‎(3)‎

• Permit No: M1977300
• IBM Index Class Name: Hydrology
• Doc Date: 10/9/2014
• Doc Name: Water Quality Data and Mine Level Measurements for June 2014- Part 3.
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: TAK
• Media Type: M
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal 4.,, S 17S76
C: P.O. Box 1750 S: P.O.Box 1750 N: P.O.Box 700
Canon City, CO 81215 Canon City, CO 81215 Nucla, CO 81424
Sample Loc./ID No. (,/ (-) s Lab. No.(s)
Sample Date ! Tune / .� `�`3 Date Data Entered
Collected By .a Data Entry By
Field Custodian Laboratory Destination if not Cotter:
Cotter Off-Site Destination
Delivered By j -:, �l�; t i 1 -./
{
Received By
f
Date Recd.
Time Recd. 3(J'
1. Sample Type: Air Water Soil Other (specify):
2. Analysis— Test series requested: r
3. Field Data—Preservation: 1^ /V f'`-
4. Date analysis required by (if not Holding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial ( ) and explain below.
COMMENTS—Explanation of noted items:
{ ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
QAC Date
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