Laserfiche WebLink
TTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FOR%J <br />S IS <br />Sample Submittal <br />C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700 <br />Cafion City, CO 81215 Caaon City, CO 81215 Nucla, CO 81424 <br />Sample Loc./ID No.%' A Lab. No.(s) <br />Sample Date Time Date Data Entered <br />Collected By Data- Entry By <br />Field Custodian R ., Laboratory Destination if not Cotter: <br />f..} <br />A, C, <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd.. <br />Cotter Oft-Ste est?nat on <br /> <br /> <br /> l? cc <br /> <br />1. Sample Type: Air Water <br />2. Analysis - Test series requested:-/ <br />1v V <br /> <br />Soil Other (specify): <br /> <br />3.> Field Data -? Preserttva(tionn: <br />?f °i.` ? ? ?';g...? •? / s f dom. 1.! ? f : • .'?! f. ?• ?. t i' ? L... if %fi? F'Ar /? ? ....t- .1 <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( ) and explain below. <br />COMMENTS - Explanation of noted items: <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO( <br />) If NO, explain: <br />QAC Date <br /> <br />