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<br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM's <br />Sample Submittal 11 S <br />C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700 <br />Callon City, CO 81215 Caton City, CO 81215 Nucla, CO 81424 <br />Sample Loc./ID No. Lab. No.(s) <br />Sample Date 2- 'U" 17 -.2 ?Vt Time <br />A%G ? <br />Collected By f ??°'• •-- <br />...- <br />Field Custodian,' <br />12 <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not.Cotter: <br /> <br />1. Sample Type: Air Water ! Soil Other (specify): <br />f• <br />2. Analysis - Test series requested: le <br />3. Field Data - Preservation: ?. ! 7 Q Sim.' <br />4. <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( <br />COMMENTS - Explanation of noted items: <br />} and explain below. <br />4V«Cr virouc ycauuaaivu <br />t ; .a/C" „ <br /> <br /> G . <br /> <br />Date analysis required by (if not Holding Time):