2011-02-03_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 2/3/2011
• Doc Name: December 2010 Discharge Monitoring Report
• From: Cotter
• To: CDPHE-WQCD
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal 2 5 S 2 6
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. D I S 001A Lab. No.(s)
Sample Date / -2 c) ` 2 d/0Time Date Data Entered
Collected By d 7--,vv.- , Data Entry By
7
Field Custodian 8 Laboratory Destination if not Cotter:
r?= ?,. ? ?' •ti
Delivered By
Received By
Date Recd.
Time Recd

1. Sample Type: Air Water v Soil Other (specify):
2. Analysis - Test series requested:
y H -7 3 ?
3. Field Data - Preservation: ,
_._DrrFAIVG
r
4. Date analysis required by (if not Holding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial
COMMENTS - Explanation of noted items:
( X ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO( ) If NO, explain:
QAC
-,, c/ 7 3 (.7 r' S
n J
) and explain below.
Date
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