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cncv Chain of Custody and Analytical Request Record <br /> 46()RA77 <br /> 'kit, PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 of 1 <br /> Company Name:Cotter Corporation Project Name: Schwartz - <br /> Tracking No 7756 2106 9049 DATE:2/9/15,S28676 <br /> Report Mail Address: Sampler Name if other than Contact: <br /> Cotter Corporation-Canon City Mill Contact Name:Frank Adamic 1-303-642-3893 mine phone <br /> PO Box 1750; Canon City, CO 81215-1750 Voice: 1-719-275-7413 ext. 204 Bob Tennant 1-719-371-3009-cell <br /> Invoice Address: Invoice Contact: JoAnne Ary Purchase Order#: ' ELI Quote#: <br /> PO Box 1750 Tei: 1-719-275-7413 ext. 209 <br /> Canon City,CO 81215-1750 Fax: 1-719-275-1669 <br /> ANAL•s SIS REQFJESTE0 Notify ELI prior to Receipt Temp <br /> Report Required For. POTW/WWTP 0 RUSH sample ei ti o C <br /> Other submittal for <br /> Special Report Formats—ELI must be notified a P additional charges <br /> Cooler iD(s) <br /> prior to sample submittal for the following: V; <br />