2011-05-11_HYDROLOGY - M1977300 ‎(5)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 5/11/2011
• Doc Name: March 2011 SW Data- 3-10-11
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal _ i ° s25687
C: P.O. Box 1750 S: P.O. Box 1750 N: P .O. Box 700
Cason City, CO 81215 Callon City, CO 81215 Nucla,- CO 81424 .
Sample LocAD No. i? [T Lab. No.(s)
Sample Date Tine- 9
Collected By ??i'?G
Field Caatodian 5 /?f.•?i?G -
Delivered By
Received By
Date Recd.
Time Recd.
1.
2.
L.vaatir VIL1101166 vcauY "Vn .
f c

u

Date Data Entered
Data Entry By
Laboratory Destination if not Cott r:
r 4 r 4p?' 1 s !?.
k?k 9.2,5 0,21,
497.
000,
Sample Type:. Air Water Soil Other (specify):
Analysis - Test series requested:A
3. Field Data -Preservation: t°& 1.0 ?a / 7 4 . S S` [.? S co/fz s " '2 oll-i
lF•;Irs/3 - em,-C11. oyW dz

analysis required by (if not Holding Time):
4 S. Special' handling conditions or other instructions:
?`. 6. Invalidating.circumstances? If YES initial ( ) and explain below.
COMMENTS - Explanation of noted items:
r
( ``heck if additional attachments.
,.1 QA Review:
:e valid? YES ( ) NO ( ) If NO, explain:
f"
i
%.
QAC
Date
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