Laserfiche WebLink
COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal i's! S 2 356 <br />C: P.O. Box 1750 S: P.O. Box 1750 <br />Canon City, CO 81215 Caiion City, CO 81215 <br />Sample Loc./ID No. So ' Lab. No.(s) <br />Sample Date Time 14y j o <br />Collected By <br />Field Custodian'` ' o . e <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />VVL?GI V1??O??G LCA??IIANUL <br /> <br /> <br />ww? <br /> <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br /> <br /> <br /> <br /> <br /> <br />1. Sample Type: Air Water/ Soil Other (specify): <br />2. Analysis - Test series requested: Yt- C4. N / vim- ` 5 ?-,, /L-' ?, :J <br />3. Field Data - Preservatio <br />n:() 7 n r? . Z?1?? <br />0. S <br />4. <br />5. <br />Date analysis required by (if not Holding Time): _ <br />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 />Sample valid? YES ( ) NO ( ) If NO, explain: <br />) and explain below. <br />N: P.O. Box 700 <br />Nucla, CO 81424 <br />QAC Date