2015-04-02_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 4/2/2015
• Doc Name: Water Quality Data And Mine Level Measurments for January 2015
• From: Cotter Corporation
• To: DRMS
• Email Name: TAK
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal
C: P.O. Box 1750 S: P.O. Box 1750
Caifon City, CO 81215 Ca$on City, CO 81215 N: P.O. Box 700
AL Nucla, CO 81424
Sample Loc./ID No. /' - `� Lab. No.(s)
Sample Date / `XJ1 - I5- rme j v
Collected By i?. .
Field Custodian if., f ,�►� ,y ,� ,,, J
Delivered By
Received By
Date Recd.
Time Recd.
Date Data Entered
Data Entry By '
Laboratory Destination if not Cotter:
A, y
L Sample Type: Air Weter e
Soil
Other (specify):
2. Analysis - Test series requested:
%f, b /,
3. Field Data - Preservation: t'
�.
; 14
j� ) 10 '
4. Date analysis required by (if not Holding Time):
S. 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
QAC
) NO ( ) If NO, explain:
Date
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