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 SUBMITTAL AND TRACKING FORM
Sample Submittal 5 2 5 2 8 5
C: Y.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700
Canon City, CO 8.1/2.15 Caiion City, CO 81215 Nucla, CO 81424
Sample Loc./ID No. ,?w, S P/- Lab. No.(s) _
Sample Date Z/- 41- 0/OTime Date Data Entered
Collected By „ )3 Data Entry By
Field Custodian Laboratory Destination if not Cotter:
Delivered By _
Received By _
Date Recd. _
Time Recd.
1. Sample Type: Air _ Water Soil
2. Analysis - Test series requested: 1-r
Other (specify):
3. Field Data - Preservation: r c G Id S V 2 4z
i
9 Al (2,
61 Z-
4. Date analysis required by (if not Holding Time):
5. Special handling conditions or other instructions
6. Invalidating circumstances? If YES initial ( ) and explain below.
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO( ) If NO, explain:
QAC _ Date