2011-02-04_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 2/4/2011
• Doc Name: 4th Quarter Ground Water Data-2
• 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
.55 37
Sample Submittal t n S 2
C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700
Carson City, CO 81215 Cafion City, CO 81215 Nucla, CO 81424
Sample Loc./ID No. /41W-7 Lab. No.(s)
Sample Date Time r 3 Date Data Entered
Collected By fs' fr'.-.'.? r. 7 Data Entry By
Field Custodian Laboratory Destination if not Cotter:
Delivered By
Received By
Date Recd.
Time Recd.
_ VULLCI WIL-0 M &Jceuuruvu

' yO ? M
1. Sample Type: Air Water Soil Other (specify):
2. Analysis - Test series requested: ?a-c-
3. Field Data - Preservation:
f 4. late analysis required by (if not Holding Time): _
S. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial
COMMENTS - Explanation of noted items:
) and explain below.
wy
O Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO( ) If NO, explain:
QAC Date