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2010-12-13_HYDROLOGY - M1977300
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2010-12-13_HYDROLOGY - M1977300
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Entry Properties
Last modified
8/24/2016 4:27:50 PM
Creation date
12/14/2010 7:40:29 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1977300
IBM Index Class Name
HYDROLOGY
Doc Date
12/13/2010
Doc Name
October 2010 Surface Water Monitoring Data- Part 1
From
Cotter
To
CDPHE-WQCD
Permit Index Doc Type
Hydrology Report
Email Name
DB2
Media Type
D
Archive
No
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Chain of Custody and Analytical Request Record <br />PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 of 1 <br />v <br />(D <br />N <br />CJ7 <br />o_ <br />N <br />CD <br />Company Name: Cotter Corporation Project Name: Schwartzwaider Water Monitoring Program - <br />Tracking No. 3692013 00179759 DATE: _10/15/10 SSTF: S 25275 --- 525276---S25277 <br />Report Mail Address: Sampler Name if other than Contact: <br />Cotter Corporation - Canon City Mill Contact Name: Kristy Usnick 1-303-642-3893 mine phone <br />PO Box 1750; Canon City, CO 81215-1750 Voice: 1-719-275-7413 ext. 213 Bob Tennant 1-719-371-3009-cell <br />Invoice Address: Invoice Contact: Kristy Usnick Purchase Order M ELI Quote <br />PO Box 1750 Tel: 1-719-275-7413 ext. 213 <br />Canon City, CO 81215-1750 Fax: 1-719-275-1569 <br /> Notify ELI prior to <br /> <br />Report Required For: POTW/WWTP C1 <br />RUSI-I sample Recei t T <br />p amp <br />Other <br />S <br />i <br />l R <br />F <br />a submittal for CSL C <br />pec <br />a <br />eport <br />ormats - ELI must be notified <br />prior to sample submittal for the followin <br />: <br /> <br />G <br />a additional charges Col r ID(s <br />g <br />AC [I A2LA C1 Level IV F-1 ? m <br />15 m <br />c°? W <br />a r and schedulin <br />g Comments: Custod I <br />Other <br /> <br />a <br />e Y <br />EDD/EDT ? Format , <br />z i z o S&A Schedule Code : <br />?. SW CODE 11 Intact <br />Y/ N <br />SAMPLE 1 1 x Table 1 Signature <br /> .e Fr <br />IDENTIFICATION Collection Collection z ° equency 1,2,3,4 Y / N <br />(Name, Location, Date Time <br />Match LAB ID <br />Interval etc MATRIX ° Y / N <br />' SW AWD ? ? ? ? ? ? ? ? ? ? ? D no sample <br />SW A001 ? ? ? ? ? ? ? ? ? ? 01 0 no sample <br />3 SW BDIS ? ? ? D ? ? ? ? ? ? ? D no sample <br />4 SW PL ? ? ? ? ? ? ? ? ? ? ? ? no sample _ <br />a Sw OS ? ? ? ? ? ? ? ? ? ? ? ? no sample <br />a SW BOS 10/14/10 15:45 ® ? ? ? ? ? ? ? ? ? 11 D Code 1 <br />7 SW GS 10/15/10 8:05 i?6)62, ® ? ? ? ? ? ? ? D D IM D Code 1 <br />a SW BPL 10/15/10 10:35 ? D ? ® ? ? ? ? ? ? ® ? Table I <br />9 ? ? ? ? ? ? ? ? ? ? ? ? <br />,a 01 0 ? ? ? ? 01 01 0 ? ? ? <br /> <br />Custody Relinquished by: Bob Tennant Date/Time:10/16/10 <br />15:30 <br />Shipped by: t <br />R d a ime: ?? VC <br />Record <br />MUST be Relinquished by: Date/Time: Shied by <br />pp Y <br />Received by: DatefTime: <br />Signed Sample Disposal: Return to Client ? Lab Disposal ® LABORATORY USE ONLY <br /> Sam le T # of fractions <br />'??c
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