Laserfiche WebLink
COTTER CORPORATION SAMPLE SI]BMITTAL AN G FO <br />Sgppl6•Subm1tt1i k � S27167t <br />C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700 <br />Callon City, CO 81215 Cation City, CO 81215 Nucla, CO 81424 <br />Sample LocJID No. ' '�` f A ° ' ' Lab. No.(s) <br />Sample Date / t <br />Collected By <br />Field Custodian ' <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />1. Sample Type: Air Water <br />2. Analysis* Test series requested: <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not 11 Cotter: <br />Son Other (specify): <br />r <br />3. Field Data - Preservation: t� ^� 17• <br />T <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 <br />COMMENTS - Explanation of noted items: <br />( ) Check if additional attachments. <br />QA Review: <br />) and explain below. <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />QAC Date <br />ta.. <br />Page 7 of 8 <br />