2015-06-17_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 6/17/2015
• Doc Name: Water Quality Data and Mine Level Measurements for March 2015
• From: Cotter Corporation
• To: DRMS
• Email Name: MAC
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal S.2 1 v 6 A:
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. Iffl.,% / z' Lab. No.(s)
Sample Datef Time / `� Date Data Entered
Collected By v c Data Entry By
Field Custodian .., Laboratory Destination if not Cotter:
Cotter Off -Site Destination
Delivered By
Received By
Date Recd.
Time Recd.
1. Sample Type: Air Water Soil
2. Analysis — Test series requested:
3. Field Data — Preservation:
y -7
4. Date analysis required by (if not Holding Time): _
5. Special handling conditions or other instructions:
Other (specify):
4 � 1
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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