Laserfiche WebLink
rv) <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKI FORM <br />• Sample Submittal a:2-SS's 1 <br />w ;. <br />• J <br />C: P.O. Box 1750 S: P.O. Box 1750 P.O. Box 700 <br />Canon City, CO 81215 Caiion City, CO 81215 Nucla, CO 81424 <br />S nzple Loc./ID No. Lab. No.(s) <br />rf f <br />Sample Date 7 61 Time Date Data Entered <br />Collected By •p??? Data Entry By <br />r <br />Laborator <br />°F)e1dCustodian ''t y Destination if not Cotter: <br />? ?• ,. -+• ? <br />Cotter. Off-Site Destination <br />Delivered By JS., •-..?...._ •?, ,'- N .,• . .. !f <br />r. Received BDate Recd. <br />y. <br />Time Recd. a <br />P I <br />r ?? <br />1 Sample Type: Air oil Other (specify): <br />Water <br />2. 'dalysis - Test series requested: try `k? <br />3. Field Data - Preserv tion: <br />4. Date analysis required -by, (if not floYdh?g Time): <br />5. Special handling conditions.-or other i*tructions: ' <br />. s` <br />6. Invalidating circuWtances? If YES initial (. ?.) and explain below. <br />,,Explanation of noted items: <br />COMMEIS?- <br /> <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO <br />r: <br />If NO, explain: -- <br /> <br />f