2011-01-12_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 1/12/2011
• Doc Name: November 2010 Surface Water Monitoring Data- 1.
• From: Cotter
• To: CDPHE- WQCD
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAI, AND TRACKING FORM
Sample Submittal "_,' _ 5 2 5 2 8 4
C: P.U. Box 1750 S: P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Caiion City, CO 81215 Nucia, CO 81424
Sample Loc./ID No, rC, 6t') (-, S Lab. No.(s)
Sample Date Time J r3 0 Date Data Entered
Collected By ?7z Data Entry By
Field Custodian Laboratory Destination if not Cotter:
Delivered By
Received By
Date Recd.
Time Recd.
I-V LLVI- Ull-Oi Lu LGa LI LLaL1Vl1

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1, Sample Type: Air _ Water soil
2. Analysis - Test series requested:
3. Field Data - Preservation: r 5f
Other (specify):
"T-z ?
L 17/ 111UU Z . S
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:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO( ) 11' NO, explain:
) and explain below,
QAC Date