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 . Si'�
C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 790
Callon City, CO 81215 Caiion City, CO 81215 Nucla, CO 81424
Sample LocJID No.�'✓� 0
i
Sample Date 11V - / S Time f %�
Collected By r r ri rr G w
Field Custodian T, r ,c r* �
Delivered By
Received By
Date Recd.
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
Time Recd.
Sample Type: Air Water Soil Other (specify):
Analysis - Test series requested: rc t' /' 2�.
1.
2.
3. Field Data - Preservation:
4.
e
Z7 Z OF
Date analysis required by (if not Holding dime):
S. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES (
QAC
) and explain below.
) NO ( ) If NO, explain:
Date
Page 17 of .19
�1
i� Lam:
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
Time Recd.
Sample Type: Air Water Soil Other (specify):
Analysis - Test series requested: rc t' /' 2�.
1.
2.
3. Field Data - Preservation:
4.
e
Z7 Z OF
Date analysis required by (if not Holding dime):
S. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES (
QAC
) and explain below.
) NO ( ) If NO, explain:
Date
Page 17 of .19